1. Visual Outcomes After Temporary Keratoprosthesis Kristin C. Bains, MD Robert Phillips, MD The authors have no financial interest in the subject matter of this poster

2. Purpose To evaluate visual outcomes after combined penetrating keratoplasty (PK) and vitreoretinal surgery using temporary keratoprosthesis (TKP)

3. Introduction Utilized in patients with coexisting corneal and vitreoretinal pathology Combined procedure necessary for adequate visualization intraoperatively If combined only with PK, delay waiting for graft to clear, leading to worsening retinal pathology Does not expose patient to risks associated with open-sky vitrectomy Attempts to restore visual function by allowing earlier surgical intervention

4. Methods IRB approval obtained Retrospective, observational case series –CPT code 65770 –Date range: 2003-2010 –55 eyes of 47 patients identified 1 corneal surgeon, multiple vitreoretinal surgeons Included: 47 eyes of 41 patients who underwent combined TKP/PK and vitreoretinal surgery Excluded: 8 eyes of 6 patients lost to follow-up Previous surgeries common

5. Baseline Characteristics Age (years)<31 31-60 >61 N=20 N=14 N=13 GenderMale Female N=31 N=16 EyeOD OS N=24 N=23 Visual acuityAmbulatory HM LP NLP N=11 N=25 N=0

6. Baseline Characteristics (cont.) Cornea statusScar Rejected graft BK N=23 N=19 N=5 Retina statusRD Attached Macular pucker Choroidal hemorrhage Vitritis Macular hole N=29 N=12 N=3 N=1 Comorbid ocular diseaseSecondary glaucoma Amblyopia Bells’ palsy Traumatic optic neuropathy Traumatic maculopathy N=11 N=3 N=1 N=2 N=1

7. Baseline Characteristics Traumatic injury Yes No N=37 N=10

8. Methods Wide-field Landers TKP Vitreoretinal procedures –3 port ppv –Pars plana lensectomy if indicated –Retinal reattachment Penetrating keratoplasty

9. Results Follow-up: 1 month- 67 months Mean pt follow-up: 23.4 months Post-operative graft status at final follow-up 17 clear (36.9%) 29 rejected 7 repeat TKP/PK 5 repeat PK

10. Results

11. Conclusions Before combined surgery 21 eyes had BCVA of ambulatory to HM. Post-operatively, majority of patients (32 eyes) had BCVA of ambulatory to HM. 93.6% of eyes (44 eyes) were retained 2.1% of eyes (1 eye) became phthisical

12. Conclusion Tool used in management of complex disease, without which, many eyes could not be salvaged Combined surgery is not without complications Outcomes can be good considering complexity of pathology