VF 70
Dohlman Type II Keratoprothesis in eyes with silicon oil tamponadeC. Redbrake, O. Arend
The rehabilitation of severely burnt eyes is often difficult because of problems of the surface. In severe cases also the posterior segment can be injured and vitrectomy and silicon oil tamponade might be necessary. Visual rehabilitation in those severely damaged eyes with conventional methods like keratoplasty is not possible in most cases.
The Dohlman type II keratoprothesis is an PMMA prothesis with a corneal and scleral rim, with which the keratoprothesis is implanted into the eye. Before implantation, covering of the bulbar suface with mucosa is necessary and most important.
The film shows the implantation of this keratoprothesis in eyes with silicon oil tamponade. Up to now three eyes were operated. In one case a severe infection occured and the eye had to be enucleated. In the other two cases a stable situation could be reached and both patients have a visual acuity at 5 m, allthough the retina was damaged by the burn as well.
As a major complication a retro-keratoprothesis membrane was observed, which could not be removed by Nd-Yag laser (as described in eyes without silicon oil), but was removed surgically. This is also demonstrated in the film.
The Dohlman type II keratoprothesis is a good alternative to other more difficult to implant keratoprothesis and can be used in eyes with silicon oil tamponade.
Dept. of Ophthalmology, RWTH Aachen, Pauwelsstr. 30, 52057 Aachen