Contact lens surveillance cultures in Boston type 1 keratoprosthesis patients

To describe surveillance cultures of bandage contact lenses (BCL) in patients with a history of Boston type 1 keratoprosthesis (KPro) surgery.

An institutional review board-approved retrospective review of patients with a history of Boston type 1 KPro surgery and BCL cultures between July 2008 and June 2010. Data on demographics, preoperative diagnosis, topical corticosteroid and antibiotic use, duration of BCL wear, clinical diagnosis of microbial keratitis or endophthalmitis, and culture results were recorded.

There were 14 patients (15 eyes) who underwent Boston type 1 KPro between July 2008 and June 2010 with BCL culture data. Ten eyes showed positive growth and one eye developed an infection. Thirty-four cultures were performed and 12 were positive. The most common organism cultured was coagulase-negative staphylococcus (CoNS). Positive cultures, colonization by non-CoNS pathogens, and infection occurred more frequently in patients with an ocular history of autoimmune disease or chemical burn. The growth of 15 or more CoNS colonies occurred only in patients not on vancomycin. An antibiotic was added to the regimen in response to positive cultures for three patients.

Contact lens surveillance cultures may provide valuable information on the characteristics of microbial colonization, particularly in highlighting inflammatory disease and disuse of vancomycin as possible risk factors. Bandage contact lenses cultures also have the potential to be useful adjuncts in the clinical management of antibiotic therapy.