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2013 Agenda and Abstracts | < Previous | Next >

2013 OMIG Abstract 13

Microbial Keratitis and Endophthalmitis after Boston Keratoprosthesis
Kang JJ, Ritterband DC, Shah MK, Wu EI, Koplin R, Seedor JA
New York Eye & Ear Infirmary, New York, NY

Purpose: To determine the incidence, clinical characteristics and outcomes of infectious keratitis and endophthalmitis after Boston type 1 keratoprosthesis (KPro) at our institution.

Methods: A retrospective chart review was performed of 112 eyes of 100 patients who received a Boston type 1 KPro at the New York Eye & Ear Infirmary from 2006 to 2013. Analysis of ocular history, culture results, antibiotic use, postoperative management, and visual outcomes was performed.

Results: Eleven eyes (9.8%) were treated for infectious complications. Three eyes (2.7%) developed microbial keratitis and 8 eyes (7.1%) endophthalmitis. Of the 11 eyes, the preoperative diagnoses were graft failure (8 eyes), limbal stem cell deficiency (2 eyes) and radiation keratitis with perforation (1 eye). Ten of 11 patients were on a topical fluoroquinolone prophylaxis and 6 of 11 patients were also using vancomycin drops. Four patients had persistent epithelial defects, 3 patients were contact lens intolerant and 1 patient admitted noncompliance with antibiotic prophylaxis. For the microbial keratitis group, the organisms isolated were bacillus cereus, staphylococcus aureus, and candida parapsilosis. In the endophthalmitis group, 3 cases were yeast (not speciated), 2 were gram positive (streptococcus mitis, propionibacterium acnes), and 1 was gram negative (sphingomonas paucimobilis). Two cases were culture negative. At final follow-up, only 2 patients retained their pre-infection best vision and 6 patients underwent either repeat KPro or penetrating keratoplasty, and 1 patient required enucleation due to intractable pain.

Conclusions: Infectious complications developed in 9.8% of eyes after Boston KPro in our series.  This high rate of infectious complications suggests the need for additional antimicrobial prophylaxis especially in eyes at high risk such as those with persistent epithelial defects.

Disclosure: N

2013 Agenda and Abstracts | < Previous | Next >