Challenges of Glaucoma Management in Patients with Type I Boston Keratoprosthesis

Type I Boston keratoprosthesis is implanted in patients with severely diseased eyes who are considered poor candidates for traditional keratoplasty. Glaucoma is considered a major visual comorbidity following the implantation of type I Boston keratoprosthesis (KPro). Eyes that receive a Boston KPro...

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Published inClinical ophthalmology (Auckland, N.Z.) Vol. 16; pp. 369 - 374
Main Authors AlHilali, Sara M, Al-Swailem, Samar A
Format Journal Article
LanguageEnglish
Published New Zealand Dove Medical Press Limited 01.01.2022
Taylor & Francis Ltd
Dove
Dove Medical Press
Subjects
boston keratoprosthesis
Care and treatment
complications
Complications and side effects
Cytokines
Development and progression
Eye
Field study
Glaucoma
management
Methods
Optic nerve
Optics
Pathophysiology
Review
Surgery
Surveillance
Tomography
Germany
Boston keratoprosthesis
surveillance
complications
management
glaucoma
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Summary:Type I Boston keratoprosthesis is implanted in patients with severely diseased eyes who are considered poor candidates for traditional keratoplasty. Glaucoma is considered a major visual comorbidity following the implantation of type I Boston keratoprosthesis (KPro). Eyes that receive a Boston KPro are at high risk of progression of pre-existing glaucoma and the development of de novo glaucoma. Both complications can limit best-corrected visual acuity postoperatively. Diagnosis and surveillance for glaucoma in KPro eyes are fundamental to mitigate the risk of visual morbidity. However, managing these patients presents several challenges. The diagnosis of glaucoma after KPro implantation is usually hindered by inaccurate intraocular pressure (IOP) measurements and unreliable ophthalmic investigations such as visual field testing and optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL). In these eyes, medical management of glaucoma with topical medications is usually insufficient, and glaucoma surgery is usually warranted either prior to or during KPro implantation. Options for glaucoma surgery include glaucoma drainage device (GDD) and cyclodestructive procedures. The aim of this article is to highlight the incidence, pathophysiology, diagnosis, and management options of glaucoma in eyes that have undergone type I Boston keratoprosthesis.
Bibliography:ObjectType-Article-2
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ISSN:1177-5467
1177-5483
1177-5483
DOI:10.2147/OPTH.S349719