Timely management of vitreoretinal complications after osteo-odonto-keratoprosthesis surgery can preserve vision

In this retrospective case series, investigators analyzed vitreoretinal complications and treatment outcomes in eyes undergoing modified osteo-odonto-keratoprosthesis (OOKP) surgery.

Study design

Ninety-two eyes of 90 patients were included in the study. Participants underwent modified OOKP surgery at a single tertiary eye-care center between 2003 and 2013. Indications for OOKP were Stevens–Johnson syndrome (n = 53), chemical injury (n = 36) and ocular cicatricial pemphigoid (n = 3).

Outcomes

A total of 41 eyes of 39 patients developed vitreoretinal complications inculding vitritis (n = 21), retinal detachment (n = 12), retroprosthetic membrane (n = 10), endophthalmitis (n = 8), vitreous hemorrhage (n = 5) and serous choroidal detachment (n = 5). Complications occurred at a mean of 43.8 months (range 0.2–95.5 months).

After addressing the vitreoretinal complication, vision improvement was seen in 17 eyes (42%) by an average of 1.2 logMAR. BCVA declined by a mean of 0.6 logMAR in 7 eyes (14%), and no changes in vision were noted in 17 eyes (42%).

Limitations

This study was limited by its retrospective nature and relatively small sample size.

Conclusions

OOKP surgery, which is shown in this clinical video, has shown promising results in patients with end-stage corneal blindness and severe dry eye. However, vitreoretinal complications constitute a significant cause of visual morbidity in eyes undergoing modified OOKP surgery, and can be challenging to manage. This study shows encouraging outcomes can be achieved with appropriate and timely intervention in these patients.