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Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis.
Cornea 2016; 35(4):486-93C

Abstract

PURPOSE

To determine the incidence, ocular surface disease associations, microbiological profile, and clinical course of postoperative infections after implantation of the Boston type 1 keratoprosthesis (KPro-1).

METHODS

A retrospective chart review was conducted of all cases of the KPro-1 performed at a tertiary eye care center between January 1, 2008, and December 31, 2014.

RESULTS

Seventy-five KPro-1 procedures were included in the analysis. Postoperative infections occurred in 13 eyes (17.3%) with an incidence of 0.064 cases per eye-year. The Kaplan-Meier probability of an infection-free graft was 0.96, 0.90, 0.88, 0.87, and 0.86 at years 1 through 5, respectively. The rate of infections was greater in eyes with ocular surface disease (26.3% vs. 8.1%, P = 0.06), especially in those with a history of chemical or thermal injury or herpes zoster keratopathy (P = 0.001). There were 8 cases (10.7%) of microbial keratitis due to either fungi (5 cases) or bacteria (3 cases). There were 7 cases (9.3%) of endophthalmitis due to bacteria (5 cases) or intraocular extension of fungal keratitis (2 cases). The incidence of microbial keratitis and endophthalmitis was 0.034 and 0.03 cases per eye-year, respectively. Therapeutic management of the infected eyes required graft and device removal in 7 eyes (53.8%). After completion of microbiologic treatment, 7 eyes (53.8%) had lost more than 2 lines of the best-corrected preinfection visual acuity, including 5 eyes with endophthalmitis that had hand motion vision or worse.

CONCLUSIONS

Postoperative infections are a serious issue that compromises device retention and visual outcomes after keratoprosthesis implantation.

Authors+Show Affiliations

*Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, University of Iowa Carver College of Medicine, Iowa City, IA; and †Cornea Research Center, Stephen A. Wynn Institute for Vision Research, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26764885

Citation

Wagoner, Michael D., et al. "Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis." Cornea, vol. 35, no. 4, 2016, pp. 486-93.
Wagoner MD, Welder JD, Goins KM, et al. Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis. Cornea. 2016;35(4):486-93.
Wagoner, M. D., Welder, J. D., Goins, K. M., & Greiner, M. A. (2016). Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis. Cornea, 35(4), pp. 486-93. doi:10.1097/ICO.0000000000000738.
Wagoner MD, et al. Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis. Cornea. 2016;35(4):486-93. PubMed PMID: 26764885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microbial Keratitis and Endophthalmitis After the Boston Type 1 Keratoprosthesis. AU - Wagoner,Michael D, AU - Welder,Jeffrey D, AU - Goins,Kenneth M, AU - Greiner,Mark A, PY - 2016/1/15/entrez PY - 2016/1/15/pubmed PY - 2016/11/4/medline SP - 486 EP - 93 JF - Cornea JO - Cornea VL - 35 IS - 4 N2 - PURPOSE: To determine the incidence, ocular surface disease associations, microbiological profile, and clinical course of postoperative infections after implantation of the Boston type 1 keratoprosthesis (KPro-1). METHODS: A retrospective chart review was conducted of all cases of the KPro-1 performed at a tertiary eye care center between January 1, 2008, and December 31, 2014. RESULTS: Seventy-five KPro-1 procedures were included in the analysis. Postoperative infections occurred in 13 eyes (17.3%) with an incidence of 0.064 cases per eye-year. The Kaplan-Meier probability of an infection-free graft was 0.96, 0.90, 0.88, 0.87, and 0.86 at years 1 through 5, respectively. The rate of infections was greater in eyes with ocular surface disease (26.3% vs. 8.1%, P = 0.06), especially in those with a history of chemical or thermal injury or herpes zoster keratopathy (P = 0.001). There were 8 cases (10.7%) of microbial keratitis due to either fungi (5 cases) or bacteria (3 cases). There were 7 cases (9.3%) of endophthalmitis due to bacteria (5 cases) or intraocular extension of fungal keratitis (2 cases). The incidence of microbial keratitis and endophthalmitis was 0.034 and 0.03 cases per eye-year, respectively. Therapeutic management of the infected eyes required graft and device removal in 7 eyes (53.8%). After completion of microbiologic treatment, 7 eyes (53.8%) had lost more than 2 lines of the best-corrected preinfection visual acuity, including 5 eyes with endophthalmitis that had hand motion vision or worse. CONCLUSIONS: Postoperative infections are a serious issue that compromises device retention and visual outcomes after keratoprosthesis implantation. SN - 1536-4798 UR - https://www.unboundmedicine.com/medline/citation/26764885/Microbial_Keratitis_and_Endophthalmitis_After_the_Boston_Type_1_Keratoprosthesis_ L2 - http://Insights.ovid.com/pubmed?pmid=26764885 DB - PRIME DP - Unbound Medicine ER -