Indications for orbital decompression for patients undergoing keratoprosthesis surgery.

INTRODUCTION: Optimizing the ocular surface and achieving acceptable cosmesis are important considerations in the rehabilitation of patients with keratoprosthesis (KPro). In osteo-odonto-KPro and type 1 Boston KPro surgery, it is important to ensure a healthy ocular surface to increase the chance of functional success. MATERIALS AND METHODS: The authors present 2 patients with KPros undergoing orbital decompression surgery. This series highlights a novel indication for orbital decompression surgery for patients, who are usually 1-eyed, undergoing KPro surgery. It illustrates the importance of globe position to either optimize the ocular surface or allow a cosmetic shell to be worn. To the authors' knowledge, such indications for orbital decompression have not been reported to date. RESULTS: Two-wall and intraconal fat orbital decompression surgery achieved globe retroplacement of 6 mm and 7 mm, allowing fitting of a cosmetic shell over the osteo-odonto-KPro and reducing lagophthalmos and corneal exposure in patients 1 and 2, respectively. CONCLUSION: Indications for orbital decompression exist in patients undergoing osteo-odonto-KPro or KPro to reduce pseudoproptosis or exposure.