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2015 Agenda and Abstracts | < Previous | Next >

2015 OMIG Abstract 21

Fungal Keratitis and Endophthalmitis after using Gamma-Irradiated Corneas as Carriers for Boston Type I Keratoprosthesis
Mansi D. Talati; Thomas F. Mauger
Department of Ophthalmology and Visual Science, The Ohio State University Wexner Medical Center

Purpose: To report 3 cases of fungal keratitis and/or endophthalmitis in patients after implantation of a Boston keratoprosthesis (Kpro) type I utilizing gamma irradiated sterile corneal grafts.

Methods:  A retrospective case series of Kpro cases using gamma irradiated sterile tissue.  All cases were treated with prophylactic topical vancomycin and moxifloxacin.  Bandage contact lenses were used post-operatively and replaced every 2-3 months after pretreatment with 5% povidine-iodine.  Three cases were complicated by fungal infection and required subsequent explantation.

Results:  Three eyes developed fungal keratitis and/or endophthalmitis.  The indication for Kpro implantation in each of these cases included corneal damage secondary to silicone oil, limbal stem cell deficiency, and multiple corneal graft failure.  Cultures revealed infection with Fusarium spp. in two eyes, while the third case was due to Candida parapsilosis.   All three cases required removal of the Kpro followed by penetrating keratoplasty with optisol stored fresh cornea ranging from 14-28 months after Kpro placement.  No recurrence of infection occurred after transplantation with fresh donor cornea.

Conclusion:  To the best of our knowledge, previous studies have evaluated gamma-irradiated sterile corneal graft use for Kpros with no evidence of keratitis or endophthalmitis within a finite follow up period.  Here, we present 3 cases of fungal infection requiring explantation of the Kpro followed by therapeutic penetrating keratoplasty with fresh cornea. 


2015 Agenda and Abstracts | < Previous | Next >