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Purpose <p>To characterize the clinical presentation, management, and outcomes of culture-proven endophthalmitis associated with the surgical use of a Boston Type I keratoprosthesis (Boston I KPro).</p> Methods <p>A retrospective consecutive case series was conducted of culture-positive cases of endophthalmitis associated with the surgical use of Boston I KPro at a single tertiary referral center. Data were collected on patient demographics, transplant history, presenting features, management strategies, and outcomes.</p> Results <p>Inclusion criteria were met by 9 eyes of 9 patients. The mean age was 76 ± 3 years. At presentation, all eyes were on chronic topical antibiotic prophylaxis. Initial vision was hand motion or worse in 8/9 (89%) of eyes. Presumed etiologies included early postoperative infection in 3/10 (30%), corneal melt with leaks in 3/10 (30%), corneal ulcer without leaks in 3/10 (30%). Vitreous cultures identified gram-positive organisms in 7/9 (78%), including <i>Staphylococcus aureus</i> in 3, <i>Streptococcus sp.</i> in 3, coagulative-negative <i>Staphylococcus</i> in 1, <i>Corynebacterium</i> in 1 and <i>Mycobacterium</i> in 1. Vitrectomy was performed in 8/9 (89%) of eyes with 3 eyes undergoing removal of the Boston I KPro. Despite prompt treatment, visual outcomes were poor with best-corrected visual acuity at last follow-up averaging 20/1600 with 2 eyes achieving ≥ 20/200 vision. Enucleation or evisceration was performed in 2 eyes.</p> Conclusions <p>Culture-proven endophthalmitis after Boston I KPro implantation is a rare, devastating complication. Patients present rapidly with severe vision loss. Management often includes prompt vitrectomy. Visual prognosis is guarded with most eyes having worse than 20/200 vision at last follow-up.</p>

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Culture-proven endophthalmitis associated with Boston Type I keratoprosthesis: clinical features, microbiologic aspects, and outcomes

  • 期刊论文

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  • 发表日期：

    2026年5月21日

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  • Charles Zhang,
  • Mariam Tadross,
  • Michael M. Massengill,
  • Guillermo Amescua,
  • Victor L. Perez,
  • Harry W. Flynn

摘要

Purpose

To characterize the clinical presentation, management, and outcomes of culture-proven endophthalmitis associated with the surgical use of a Boston Type I keratoprosthesis (Boston I KPro).

Methods

A retrospective consecutive case series was conducted of culture-positive cases of endophthalmitis associated with the surgical use of Boston I KPro at a single tertiary referral center. Data were collected on patient demographics, transplant history, presenting features, management strategies, and outcomes.

Results

Inclusion criteria were met by 9 eyes of 9 patients. The mean age was 76 ± 3 years. At presentation, all eyes were on chronic topical antibiotic prophylaxis. Initial vision was hand motion or worse in 8/9 (89%) of eyes. Presumed etiologies included early postoperative infection in 3/10 (30%), corneal melt with leaks in 3/10 (30%), corneal ulcer without leaks in 3/10 (30%). Vitreous cultures identified gram-positive organisms in 7/9 (78%), including Staphylococcus aureus in 3, Streptococcus sp. in 3, coagulative-negative Staphylococcus in 1, Corynebacterium in 1 and Mycobacterium in 1. Vitrectomy was performed in 8/9 (89%) of eyes with 3 eyes undergoing removal of the Boston I KPro. Despite prompt treatment, visual outcomes were poor with best-corrected visual acuity at last follow-up averaging 20/1600 with 2 eyes achieving ≥ 20/200 vision. Enucleation or evisceration was performed in 2 eyes.

Conclusions

Culture-proven endophthalmitis after Boston I KPro implantation is a rare, devastating complication. Patients present rapidly with severe vision loss. Management often includes prompt vitrectomy. Visual prognosis is guarded with most eyes having worse than 20/200 vision at last follow-up.