Management of glaucoma associated with boston kpro type i implantation

Abstract

Glaucoma affects a majority of eyes undergoing Boston Type I Keratoprosthesis (KPro; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA) surgery and is associated with poorer postoperative outcomes. Pathophysiologic factors include underlying disease process, synechial angle closure, steroid-response intraocular pressure (IOP) elevation, and possible pupillary block. Frequent monitoring with structural and functional testing measures is required to allow for timely interventions. Glaucoma drainage implant (GDI) surgery offers a relatively effective method for IOP control, but may be fraught with long-term complications including implant/tube exposure, endophthalmitis, and KPro extrusion. A modified GDI surgical technique involving pars plana tube insertion as posterior to the corneal limbus as possible and use of a lamellar-dissected corneal patch graft may decrease the risk of postoperative complications and allow for a successful patient outcome.