Glaucoma Surgery in Boston Type 1 Keratoprothesis Patients at the University of Montreal Hospital Center
Purpose
To evaluate glaucoma progression and the role of glaucoma surgery in Boston type 1 keratoprosthesis (KPro) patients.
Methods
A retrospective study of all KPro-implanted patients (117 eyes in 101 patients) between October 2008 and May 2014 in a university center. All eyes were included and comparatively evaluated: patients with glaucoma surgery prior to KPro (group 1; n=23 eyes), patients with glaucoma surgery post KPro (group 2; n=23 eyes), and KPro patients without glaucoma
surgery (group 3; n=49 eyes). KPro-implanted eyes without a diagnosis of glaucoma (group 4; n=22) were also examined. Outcome measures examined included visual acuity (VA), intraoperative and postoperative complications, intraocular pressure (IOP), optic nerve
status (cup-to-disc ratio, C/D), and glaucoma management.
Results
Glaucoma prevalence was 65.8% before KPro and de novo prevalence was 16.2% after KPro. Mean follow-up time was 42.7 months. At 12, 18, and 24 months postoperatively, group 2 had significantly better VA than group 3 (p=0.0131, p=0.0101, and p=0.0021 respectively). At 12 and 24 months, IOP in group 2 was significantly higher than in group 3 (p=0.0502, and p=0.0227), with glaucoma surgery taking place at a mean of 21.8 months. At 24 and 36
months, C/D ratios for group 3 were significantly lower than group 1 (p=0.0005 and, p=0.0058).
Conclusion
This cohort suggests that early glaucoma surgery post KPro implantation may be of benefit.