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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Biomaterials Science

Background:

  • Keratoprosthesis implantation is a sight-restoring procedure for severe corneal diseases.
  • Infections, including microbial keratitis and endophthalmitis, remain significant complications.
  • Post-keratoprosthesis infections pose challenges due to altered ocular anatomy and potential for resistant organisms.

Purpose of the Study:

  • To review recent advancements in diagnosing and treating microbial keratitis and endophthalmitis following keratoprosthesis surgery.
  • To highlight changes in infection patterns and effective management strategies.
  • To identify areas for future research and development in keratoprosthesis care.

Main Methods:

  • Review of recent literature on post-keratoprosthesis infections.
  • Analysis of treatment outcomes with combined antibiotic regimens.
  • Evaluation of emerging trends in microbial keratitis and endophthalmitis.

Main Results:

  • Daily vancomycin combined with a fluoroquinolone significantly reduced bacterial keratitis and endophthalmitis.
  • A notable increase in documented fungal infections has been observed post-operatively.
  • This shift in infection profile necessitates a re-evaluation of prophylactic and therapeutic strategies.

Conclusions:

  • Lifelong adherence to a fluoroquinolone and vancomycin regimen is essential for patients with keratoprosthesis.
  • Further research into intermittent povidone-iodine use and bandage contact lens management may help mitigate fungal infections.
  • Advancements in Boston keratoprosthesis design and postoperative care are needed to further minimize infection risks.