Endoscopic vitrectomy improves outcomes of Seoul-type keratoprosthesis exchange in rabbit model

Abstract

PURPOSE: To investigate the efficacy of an endoscopic vitrectomy in Seoul-type keratoprosthesis (S-Kpro) exchange procedures. METHODS: Nine S-Kpro-implanted rabbit eyes were enrolled in the S-Kpro exchange. Six eyes underwent an antecedent vitrectomy by an endoscopic system and then the S-Kpro exchange (endoscopy group). In the other three eyes, previously placed S-Kpros were removed, and a conventional vitrectomy was performed using the Eckardt keratoprosthesis, followed by an implantation of new S-Kpros (Eckardt group). All eyes were evaluated with slit lamp biomicroscopy and ultrasonography weekly to evaluate the time up to the development of the total retinal detachment (RD). RESULTS: Vitreous traction membranes were found around the prolene haptics of the fixation sites in all the S-Kpro implanted rabbits; they were excised precisely through an endoscopic view in the endoscopy group. The mean survival time up to the RD development was 9.75 +/- 4.70 weeks in the endoscopy group. In contrast, total retinal detachment or dialysis over 180 degrees developed during surgery in all three eyes in the Eckardt group. CONCLUSIONS: Antecedent endoscopic vitrectomy was safe and effective for the S-Kpro exchange in a rabbit model by removing the vitreous traction near the haptics before the exchange procedures.