Characteristics of Endophthalmitis in Patients With the Boston Keratoprosthesis

Fintelmann, Robert E.; Maguire, Joseph I.; Ho, Allen C.; Chew, Hall F.; Ayres, Brandon D.

doi:10.1097/ico.0b013e31819b0385

Cited by 51 publications

(42 citation statements)

References 5 publications

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“…In our series, the underlying disease was OCP in two of our patients and severe alkali burn in the remaining. Although all of the infections reported in the literature were due to gram-positive cocci [6,10], vitreous and aqueous cultures in our patients failed to isolate a responsible micro-organism.…”

Section: Discussioncontrasting

confidence: 59%

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Georgalas

Kanelopoulos

Petrou

et al. 2009

Graefes Arch Clin Exp Ophthalmol

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We present our experience from managing presumed bacterial endophthalmitis with 25 g PPV in patients previously implanted with Boston Kpro, which to the best of our knowledge has not been reported before. Although the number of cases is small to draw accurate conclusions, we have to report that 25 g vitrectomy was performed without significant difficulties and seems to be a useful tool for the management of patients with Kpros requiring vitreoretinal surgery.

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Section: Discussioncontrasting

confidence: 59%

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Georgalas

Kanelopoulos

Petrou

et al. 2009

Graefes Arch Clin Exp Ophthalmol

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“…But the common factor was the symptom of pain in all cases compared to only 25 % patients complaining pain in post-cataract surgery endophthalmitis in the endophthalmitis vitrectomy (EVS) study [7]. The incidence of endophthalmitis at 11.1 % in our study was between other reported incidences in literature (11.4 % and 12 [5,6]-2.5 % and 2.4 % [3,5,6,8,9]), but 158-fold higher than the incidence of endophthalmitis after cataract surgery in our institute (0.07 % culture proven endophthalmitis [10]) and 55-fold higher than penetrating keratoplasty (0.2 %). Other differences included equal distribution of bacterial and fungal infection; but this cannot be concluded emphatically due to small numbers (Table 2).…”

Section: Discussionmentioning

confidence: 42%

“…Since this device bridges the non-sterile ocular surface with sterile anterior chamber, there is increased risk of rapid invasion of pathogenic organisms through the space between the tissue and the prosthesis [2]. Additionally, infectious endophthalmitis may occur months or years after K-Pro placement [3][4][5][6]. We report the clinical characteristics, management and outcomes of five patients who developed endophthalmitis following Boston K-Pro type 1.…”

Section: Introductionmentioning

confidence: 99%

Erratum to: Endophthalmitis in Boston keratoprosthesis: case series and review of literature

et al. 2015

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To report the clinical and microbiological characteristics of infectious endophthalmitis after Boston type I keratoprosthesis (B-K-Pro) implantation. Retrospective analysis of 45 eyes that received a B-K-Pro type 1 between 2009 and 2012 was performed. Five eyes with a diagnosis of exogenous endophthalmitis after B-K-pro type 1 were identified and information about demographic data, indication for K-Pro, post-operative bandage contact lens use, post-operative prophylactic antibiotic use, timing and clinical presentation of endophthalmitis, gram stain and culture results of intraocular fluid and preoperative and post-operative visual acuity were collected. The incidence of endophthalmitis was 11.1 % (5 of 45 eyes) and average time to develop endophthalmitis was 5.62 months (range 2 days to 8 months). Mean patient age was 31.4 years (5 to 65 years). The surgical indications included corneal injury due to chemical burns (n = 2), multiple failed grafts secondary to microbial keratitis (n = 2) and congenital glaucoma with congenital herpetic keratitis (n = 1). Post-Boston K-Pro, the visual acuity ranged from light perception (LP) to 20/50. K-pro was explanted in 4 patients. There was bacterial and fungal growth in two patients each and one vitreous did not grow anything. All the eyes were phthisical at last visit. Infectious endophthalmitis after K-Pro implantation in our study had a higher incidence, early onset and extremely poor visual outcome compared with post-cataract surgery endophthalmitis, as reported in literature. Not only bacterial but also fungal infections are an important etiology for infectious endophthalmitis in these cases.

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“…The greatest visionthreatening risk facing patients with any type of keratoprosthesis is bacterial endophthalmitis, most cases associated with Grampositive pathogens (2,24,27) . Early recogni tion and aggressive treatment are crucial for favorable results in the ses cases (28) . Since 1990, topical antibiotic prophylaxis has been used to prevent bacterial endophthalmitis in patients with the Bos ton KPro (25) .…”

Section: Postoperative Management and Complicationsmentioning

confidence: 99%

Boston type I keratoprosthesis: Review

Magalhães

Sousa

Oliveira

2012

Arq. Bras. Oftalmol.

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Regardless of significant progress in the field of corneal transplantation to treat cor neal opacification, some cases of corneal blindness still present a poor prognosis for conventional penetrating keratoplasty. In patients with repeated graft fai lure and/or with severe ocular surface disease, the Boston type I keratoprosthesis (type I BKPro) has become a viable option. Modifications in its design and postoperative management have improved the longterm outcomes of visual acuity, retention, and postoperative infection rates. These advances made the type I BKPro be considered a safe alternative for visual rehabilitation in many patients with corneal pathologies. However, postoperative handle of chronic comorbidities, such as glaucoma, is still critical for preserving the visual gains achieved with BKPro.

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Characteristics of Endophthalmitis in Patients With the Boston Keratoprosthesis

Cited by 51 publications

References 5 publications

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases

Erratum to: Endophthalmitis in Boston keratoprosthesis: case series and review of literature

Boston type I keratoprosthesis: Review

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