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      Transscleral Cyclophotocoagulation for the Treatment of Uncontrolled Glaucoma in a Boston Keratoprosthesis Type II Patient


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          Postoperative endoscopic cyclophotocoagulation (CPC) for the treatment of glaucoma in patients with Boston keratoprosthesis type II (BKPro II) was first described in 2017 by Poon et al. ( Endoscopic cyclophotocoagulation for the treatment of glaucoma in Boston keratoprosthesis type ii patient. J Glaucoma. 2017 Apr;26(4):e146–9 ). As we do not have this device, we present a case of transscleral CPC (TSCPC), in a BKPro II patient who had graft versus host disease and developed uncontrolled glaucoma. We dissected plane by plane to expose the bare sclera and performed the procedure as traditionally described. We concluded that this is a safe, controlled, and effective option in this patient population where the glaucoma treatment options are very limited. To the best of our knowledge, this is the first case report to describe the surgical technique of TSCPC in a BKPro II patient.

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          Most cited references18

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          Update on results and complications of cyclophotocoagulation.

          This review highlights recently published studies on transscleral and endoscopic diode cyclophotocoagulation (TCP, ECP) and summarizes the treatment results and complications.
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            Glaucoma associated with keratoprosthesis.

            This study aimed to review the authors clinical experience with glaucoma associated with keratoprosthesis in patients with severe corneal disease. The study design was a retrospective review of case series. The authors studied 55 eyes in 52 patients with keratoprostheses with follow-up of 21 +/- 16 months (range, 3-77 months). Glaucoma drainage devices were implanted in 36 eyes (35 Ahmed valves, 1 Krupin valve) with 21 +/- 15 months' follow-up (range, 3-64 months). Clinical outcome assessment included vision, intraocular pressure (IOP), visual fields, optic disc appearance, and identification of complications. Glaucoma was found in the majority (64%) of eyes treated with keratoprostheses, identified in 20 eyes (36%) before surgery and an additional 15 eyes (28%) after surgery. Of the 36 eyes treated with glaucoma drainage devices, IOP was controlled in 29 eyes (81%), with 9 eyes (25%) requiring additional medications. Continued progression of glaucoma occurred in 5 (14%) of 36 eyes with keratoprostheses and glaucoma drainage implants (4 of these eyes had advanced glaucomatous optic nerve damage before surgery). There were nine nonvision-threatening complications due to drainage implants. Compared with the preoperative visual acuity, vision was markedly improved in 63%, unchanged in 17%, and worse in 20% of eyes after keratoprosthesis surgery. Elevation of IOP is common in patients with keratoprosthesis, and prevention or treatment with glaucoma drainage implants is effective.
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              • Article: not found

              Glaucoma progression and role of glaucoma surgery in patients with Boston keratoprosthesis.

              The aim of this study was to evaluate glaucoma onset and progression after implantation of Boston Keratoprostheses (B-KPro) and the role of glaucoma surgery.

                Author and article information

                Case Rep Ophthalmol
                Case Rep Ophthalmol
                Case Reports in Ophthalmology
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                Jan-Apr 2022
                17 March 2022
                17 March 2022
                : 13
                : 1
                : 158-165
                [1] aDepartment of Ophthalmology, BioCruces Bizkaia Health Research Institute, University Hospital of Cruces, Begiker, Plaza de Cruces S/N, Barakaldo, Spain
                [2] bSurgical Center Rožna Dolina, Ljubljana, Slovenia
                [3] cDepartment of Ophthalmology, University Hospital of Galdakao-Usansolo, Labeaga Auzoa, Galdakao, Spain
                [4] dDepartment of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
                Author notes
                *Ana Orive Bañuelos, orive.a@ 123456hotmail.com
                Copyright © 2022 by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                : 27 December 2021
                : 3 February 2022
                : 2022
                Page count
                Figures: 4, References: 18, Pages: 8
                Case Report

                boston keratoprosthesis type ii,transscleral cyclophotocoagulation,glaucoma,intraocular pressure,scleral pressure


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