Angle closure after Boston keratoprosthesis

J Glaucoma. 2013 Dec;22(9):725-9. doi: 10.1097/IJG.0b013e318259b2fc.

Abstract

Purpose: To evaluate changes in the anterior chamber angle after Boston keratoprosthesis (KPro) placement.

Patients/methods: Ten patients were serially imaged with anterior segment optical coherence tomography after Boston KPro surgery. Angles were judged to be open or closed in the horizontal axis.

Results: Seven of 10 patients had open angles before KPro placement. Within 4 months, 4 of 7 patients developed angle closure. Contact between the iris and the backplate was seen in 3 of these patients. Two of the 4 eyes demonstrated progressive angle closure. Intraocular pressure was elevated in 3 patients postoperatively due to the obstruction of a glaucoma drainage device tube (1 eye) and angle closure (2 eyes).

Conclusions: After Boston KPro surgery, patients must be carefully monitored for the onset or progression of glaucoma. Progressive angle closure can occur after placement of a Boston KPro and may be seen in conjunction with irido-backplate touch.

MeSH terms

  • Anterior Eye Segment / pathology*
  • Bioprosthesis*
  • Corneal Diseases / surgery*
  • Corneal Transplantation*
  • Follow-Up Studies
  • Glaucoma, Angle-Closure / diagnosis
  • Glaucoma, Angle-Closure / etiology*
  • Glaucoma, Angle-Closure / therapy
  • Humans
  • Intraocular Pressure
  • Postoperative Complications*
  • Prospective Studies
  • Prostheses and Implants
  • Tomography, Optical Coherence
  • Visual Acuity / physiology