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Combined surgery can save vision in eyes with corneal and vit/ret disease
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COLOGNE, Germany — A combination of surgical procedures may preserve or improve vision in patients with both corneal and vitreoretinal diseases, according to surgeons here.
Graft failure can often follow combined vitreoretinal surgery and penetrating keratoplasty. Sigrid Roters and colleagues used a staged surgical procedure combining pars plana vitrectomy with temporary keratoprosthesis, vitreoretinal surgery, and then penetrating keratoplasty with intravitreal silicone oil. They retrospectively evaluated the long-term corneal clarity of 53 eyes that underwent the combined surgical procedures between 1991 and 1998. Follow-up ranged from 12 to 84 months.
At the final visit, 58% of the eyes had a better visual acuity (VA) than preoperatively, and 73% had equal or better VA. The cornea remained clear in 68% of eyes.
Causes of VA decrease included loss of light perception in two eyes, hypotony or phthisis in 23 eyes, recurrent retinal detachment in four eyes that were operated on because of trauma and immunological reaction in two eyes. Preoperative factors that contributed to a clear graft (but were not significant) included lack of trauma, no silicone oil filling, preop VA of hand movement or better and attached retina.
The study is published in the February issue of Graefe’s Archive for Clinical and Experimental Ophthalmology.