Glaucoma associated with KPros

Purpose Glaucoma is one of the most serious problems in Keratoprostheses. Already glaucoma is very frequent in patients with severe changes of the ocular surface requiring keratoprosthesis surgery. About 50% of those patients have pre‐existing secondary glaucoma. Preoperatively all efforts should be done to detect its presence very early on. In KPro detection of glaucoma with traditional aids is difficult. A rough estimation of the tension by digital palpation will be the only available method. All indirect clues such as the medical history of glaucoma, echographic signs of disc cupping and anterior synechiae and examination of the visual field should be considered. Methods The incidence of postoperative secondary glaucoma vary among the different kinds of prostheses according to the surgery affecting the anterior segment and the long term anatomic results. In Osteo‐Odonto‐Keratoprostheses (OOKP) the most vision threatening complication is a primary or secondary glaucoma, due to the extended interventions required in the anterior segment. In Boston Keratoprostheses the risk seems to be somehow less. Results As the absorption of topical anti‐glaucomatous medication will not reach the inner eye because of the anatomic barrier in KPro the only promising possibilities of treatment are systemic carbonic anhydrase inhibitors, different kinds of aqueous shunts and endo‐cyclo‐laserphotocoagulation. Conclusion Glaucoma is still a mayor problem in KPro. PS: This lession will be presented at the KPro‐Meeting!!