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2003 OMIG, Abstract 13

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Fungal Colonization in Keratoprosthesis
Scott D. Barnes, Claes H. Dohlman, Barbara Paton, Marlene L. Durand

Purpose: To determine the risk and incidence of fungal colonization in keratoprosthesis (Kpro) patients.
Methods: After one case (out of 210 patients) of fungal endophthalmitis, surveillance cultures were obtained in 80 keratoprosthesis patients from August 2002-July 2003. All patients were using topical corticosteroids, fluoroquinolones, and fortified vancomycin. The patient population included those with type I (normal lid function over KPro) and type II (KPro extending through surgically closed lid) devices with a mixture of medical diagnoses (Stevens-Johnson, pemphigoid, ocular burns, and graft failure). Topical amphotericin B was initiated in 5 of the patients.
Results: Fungal colonization was detected in 10 patients. The average time from date of surgery to date of positive colonization was 18.6 months with a range of 3-57 months. No statistical difference regarding type of Kpro was noted; however, there was a trend toward positive cultures in the Stevens-Johnson and pemphigoid patients compared to the ocular burn and graft failure groups.
Conclusions: Fungal colonization appears to be more prevalent than originally thought. More frequent surveillance of colonization and prophylactic Amphotericin B may be advisable.


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