Management of Glaucoma Following Boston Keratoprosthesis

Abstract

Boston keratoprosthesis (KPro) surgery has revolutionised the treatment of corneal and ocular surface disease. At present, glaucoma is the most important vision-threatening complication following KPro surgery. Diagnosis of glaucoma in KPro patients is difficult since the current method of determining intraocular pressure (IOP) by digital palpation is subjective and dependent upon the skill of the examiner. Optic nerve evaluation and visual field testing are important tools to follow glaucoma progression. Management of glaucoma following Boston KPro consists of medical therapy and surgical options. Glaucoma drainage devices are useful in this population but can have a variety of complications. Cyclophotocoagulation, either the non-invasive transscleral method or endocyclophotocoagulation, is also useful as an adjunctive measure in glaucoma management. Appropriate diagnosis and management of glaucoma is essential after KPro surgery to reduce the chance of vision loss.