Michael Banitt1. 1. University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136, USA. mbanitt@med.miami.edu
Abstract
PURPOSE OF REVIEW: To review the causes and treatment of glaucoma in Boston keratoprosthesis (K-pro) recipients. RECENT FINDINGS: Glaucoma exists in up to three-quarters of patients who undergo K-pro surgery. After K-pro placement, intraocular pressure (IOP) is measured by digital palpation, which has been found to be reliable in trained observers. The onset or progression of glaucoma in K-pro patients should be monitored through visual field testing, direct visualization and structural imaging of the optic nerve. Although medical therapy is an option, one-half to three-quarters of K-pro recipients are surgically managed with a glaucoma drainage device (GDD) or, less commonly, cyclophotocoagulation. SUMMARY: Glaucoma is a common and permanent blinding sequelae of K-pro surgery. In K-pro patients, elevated IOP and changes in the optic nerve head should result in a high index of suspicion for glaucoma. Management is frequently surgical and typically entails placement of a GDD.
PURPOSE OF REVIEW: To review the causes and treatment of glaucoma in Boston keratoprosthesis (K-pro) recipients. RECENT FINDINGS:Glaucoma exists in up to three-quarters of patients who undergo K-pro surgery. After K-pro placement, intraocular pressure (IOP) is measured by digital palpation, which has been found to be reliable in trained observers. The onset or progression of glaucoma in K-propatients should be monitored through visual field testing, direct visualization and structural imaging of the optic nerve. Although medical therapy is an option, one-half to three-quarters of K-pro recipients are surgically managed with a glaucoma drainage device (GDD) or, less commonly, cyclophotocoagulation. SUMMARY:Glaucoma is a common and permanent blinding sequelae of K-pro surgery. In K-propatients, elevated IOP and changes in the optic nerve head should result in a high index of suspicion for glaucoma. Management is frequently surgical and typically entails placement of a GDD.
Authors: Maria Fideliz de la Paz; Josef Stoiber; Valeria de Rezende Couto Nascimento; Juan Alvarez de Toledo; Orang Seyeddain; Wolfgang Hitzl; Günther Grabner; Rafael I Barraquer; Ralph Michael Journal: Graefes Arch Clin Exp Ophthalmol Date: 2013-10-25 Impact factor: 3.117
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