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2012 Agenda and Abstracts | < Previous | Next >

2012 OMIG Abstract 4

Streptococcal Endophthalmitis in Pediatric Keratoprosthesis Patients
A.V. Rachitskaya1, A.M. Berrocal1, S.N. Moysidis2, V.L. Perez1, M.R. Banitt1, E.C. Alfonso1
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL; 2University of Miami, Miller School of Medicine, Miami, FL

Purpose: To report three cases of culture positive endophthalmitis in children with Boston type I and II Keratoprostheses.

Methods: This is a retrospective case series of three children with Boston Keratoprostheses who developed culture positive infectious endophthalmitis. Data collected included (1) demographic information (2) past ocular history such as prior diagnoses and ocular surgeries (3) age at the time of keratoprosthesis surgery (4) visual acuity after implantation, use of prophylactic antibiotics, and utilization of the bandage contact lens (5) time from implantation to the development of endophthalmitis as well as subsequent course including the presenting visual acuity, treatment, cultured organisms, susceptibilities, and final visual outcome.

Results: Three patients from ages 3 to 5 years presented with streptococcal endophthalmitis 1 to 13 months after keratoprosthesis implantation. All patients had multiple previous surgeries; one child carried a diagnosis of Peters anomaly, one of sclerocornea, and one of Stevens-Johnson syndrome. The organisms isolated included Streptococcus pneumoniae, Streptococcus agalactiae, and Streptococcus viridans. Two of the patients grew organisms sensitive to the prophylactic antibiotics that were being used. Biofilm formation was documented on one of the extruded keratoprostheses by confocal and scanning electron microscopy. The final visual outcome of all the patients was no light perception vision. One eye was enucleated.

Conclusions: Infectious endophthalmitis represents a previously unreported visually devastating complication of pediatric Boston Keratoprosthesis surgery.

Disclosure: G     This research is funded in part by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD- Grant#W81XWH-09-1-0675). The sponsor or funding organization had no role in the design or conduct of this research.

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