Penetrating Keratoplasty Surgery Combined With Vitrectomy After Failing Previous Corneal Surgery

Abstract

The outcome was poor in eyes with goniosynechia and ocular hypotony, and combined surgery is not indicated for either anatomic or visual preservation in such cases. Care should be taken not to overlook intraocular infection in patients undergoing immunosuppressive therapy against graft rejection. The early detection of retinal detachment is also important in eyes exhibiting hypotony after surgery.

Outcomes of combined keratoplasty and pars plana vitrectomy for endophthalmitis with compromised corneal clarity

“…11 The rate of development of endophthalmitis in patients with MK has been reported to be in the range of 0.7% to 1.7% and often carries a poor visual prognosis. 5 Most other studies on combined MK and endophthalmitis have reported bacterial growth only. Any discontinuity in the posterior capsule provides a tract for the microbes to travel to the posterior segment even with a trivial anterior segment infection.…”

“…Visual rehabilitation is often difficult and of secondary consideration. 5 Their series had seven cases of fungal endophthalmitis. 10 The prognosis becomes much poorer if it is associated with microbial keratitis or corneal opacification.…”

“…One reason for it could be early surgical intervention in all the cases which helps in de-bulking the infectious load. [4][5][6][7][8][9] We preferred using the Landers TKP in comparison to Eckardt's as it provides a good view of the central retina and vitreous which is needed for core vitrectomy. 1,2 In our study nearly one-third of eyes showed fungus on microbiological evaluation.…”

“…1 Endophthalmitis commonly results as a complication of intraocular surgery or trauma. [4][5][6][7][8][9] But most of these studies have included non-infectious causes of combined anterior and posterior segment diseases. In addition endophthalmitis can also result as a complication of MK and it has been reported that 0.7-1.7% of MK can progress to endophthalmitis.…”

Anatomical Outcome of Vitreoretinal Surgery Using Temporary Keratoprosthesis and Replacement of the Trephined Corneal Button for Severe Open Globe Injuries: One-Year Result

“…If PKP is performed on such eyes, the success rate will dramatically be reduced due to insufficient nourishment of the cornea, which is caused by an inadequate aqueous flow and an unavoidable silicone oil-endothelium contact [9–11]. Roters et al [3] reported a series of 34 severely injured eyes that underwent the PPV + TKP + PKP procedure; 8 eyes were considered phthisical and 10 eyes had a longstanding hypotony.…”