![]() Of 23 cases, 22 underwent a 3-port small-gauge (23- or 25-gauge) vitrectomy ( Figure, A) one case was via an open-sky approach. To the best of our knowledge, this is the largest series of eyes with KPro that have undergone small-gauge vitrectomy. The aim of our study was to describe and review the practicability and the anatomic and visual outcomes of, and the techniques used in, small-gauge vitrectomy in 23 cases performed on 14 eyes with a KPro. 5 Although management of endophthalmitis in eyes that have undergone KPro with 25-gauge vitrectomy was recently described, a comprehensive update on vitreoretinal surgical techniques with these implants has not been undertaken. 4 With continued refinements in instrumentation, there are ever-expanding indications for small-gauge vitrectomy. 3 Since that report, the preferences of vitreoretinal surgeons have shifted from 20-gauge vitrectomy to predominantly small-gauge sutureless procedures. The last comprehensive overview of vitreoretinal techniques in this setting was published nearly a decade ago. 1, 2 The increasing use of KPro, however, comes with the challenge of managing inevitable posterior segment complications in eyes that have undergone a KPro. Improved outcomes and expanding indications have increased the use of a permanent Boston Type 1 keratoprosthesis (hereafter referred to as a KPro) for visual rehabilitation. Vitrectomy and glaucoma tube revision by a team of subspecialists at the time of KPro placement may reduce subsequent complications. Visual acuity, frequently limited by preexisting pathology, improved in most cases.Ĭonclusions Modern posterior segment surgical techniques, including small-gauge sutureless vitrectomy, can be effectively used for patients with a permanent KPro. Anatomical goals were achieved, and no serious complications directly resulted from these techniques. Retro-KPro membranes formed less frequently when vitrectomy was performed during KPro placement. Results Established and innovative techniques were used, including sutureless small-gauge vitrectomy, temporal positioning of surgeon, long-term tamponades, and exploratory endoscopy. Methods Retrospective review of 23 small-gauge vitreoretinal surgical procedures during or after Dohlman-Doane KPro placement in 14 eyes. ![]() Objectives To evaluate the surgical management of vitreoretinal pathology in patients with a permanent Boston Type 1 keratoprosthesis (hereafter referred to as a KPro) in the era of small-gauge vitrectomy techniques. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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