Vitreous surgery and keratoprosthesis helpful in 'hopeless' eyes

Donald J. D'Amico, MD, described the use of vitreous surgery with K-pro implantation.

WAILEA, Hawaii — Vitreous surgery combined with keratoprosthesis surgery “salvages very useful vision in an increasing number of hopeless eyes,” according to one vitreoretinal surgeon. At Retina 2006, held in conjunction with Hawaiian Eye 2006, Donald J. D'Amico, MD, described the use of vitreous surgery in combination with implantation of a permanent keratoprosthesis, or K-pro. He said K-pro surgery can be used in patients whose eyes might otherwise be considered “hopeless,” including patients with trauma, chemical burns, repeated graft failure and chronic uveitis.

Dr. D'Amico said his management plan for these patients includes intraocular endoscopy to see if the retina is operable. If it is, he performs implantation of the K-pro and waits 3 weeks until the eye heals. Then he performs vitreous surgery using the K-pro for visualization.

He said that in a series of 17 patients, mean visual acuity was 20/400 before surgery and 20/200 postoperatively.

“Piano is a great adjunct for surgical skills,” Dr. Rosenthal said. “It allows you the ability to perform a number of simultaneous tasks. It also gives you physical dexterity and is a great form of relaxation and emotional expression.”

Dr. D'Amico warned surgeons that “vitreoretinal complications are frequent and occur due to previous disease.” He said more refinement of the surgical instruments and techniques is still needed.