June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Clinical features and outcomes of patients with culture positive endophthalmitis after penetrating keratoplasty
Author Affiliations & Notes
  • Kimberly D Tran
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nicolas Alessandro Yannuzzi
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Nancy Si
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Wei She
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Harry W Flynn
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Kimberly Tran, None; Nicolas Yannuzzi, None; Nancy Si, None; Wei She, None; Harry Flynn, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3876. doi:
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      Kimberly D Tran, Nicolas Alessandro Yannuzzi, Nancy Si, Wei She, Harry W Flynn; Clinical features and outcomes of patients with culture positive endophthalmitis after penetrating keratoplasty. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3876.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The purpose of this study was to determine the clinical features, bacterial isolates, antibiotic sensitivities, and visual outcomes of patients with culture positive endophthalmitis after penetrating keratoplasty (PKP).

Methods : Retrospective case series of patients with culture positive endophthalmitis after PKP from 1/1/2006-12/31/2016. Patients who had undergone therapeutic PKP for infectious keratitis or other intraocular procedures within 30 days prior to endophthalmitis were excluded.

Results : 11 eyes of 11 patients were included. The median age was 66 years (range 42-80), 5/11 (46%) Males, and mean follow-up time was 74 months (range 11-214). The mean time from most recent PKP to endophthalmitis was 175 days (range 2-924) with frequency within postoperative week one 3/11 (27%), postoperative month one 3/11 (27%), and thereafter 5/11(46%). Gram positive (GP), gram negative (GN), gram variable bacteria and fungal comprised 9/11 (82%), 1/11 (9%), 0/11 (0%) and 1/11 (9%) respectively. The frequency of isolates was Staphylococcus aureus 1/11 (9%), coagulase negative Staphylococcus species 5/11 (45%), Streptococcus species 2/11 (18%), Enterococcus 1/11(9%), Pseudomonas aeriginosa 1/11(9%), and Candida albicans 1/11 (9%). Of GP bacteria tested, 9/9 (100%) were sensitive to Vancomycin. Of GN bacteria tested 0/1 (0%) were sensitive to Amikacin and/or Ceftazidime. Of fungal isolates tested 0/1 (0%) were sensitive to Amphoteracin, Fluconazole, and/or Voriconazole. 1/7 (14%) donor rims were culture positive for Candida glabrata and 6/7 (86%) were culture negative. 1/11 (9%) donors were retrospectively contraindicated (died of sepsis).The frequency of VA on presentation of endophthalmitis was NLP 0/11 (0%), LP 6/11 (54.5%), HM 3/11(27.3%), CF 0/11 (0%), better than CF 2/11 (18.2%). The frequency of final VA at last follow up was NLP 1/11 (9.1%), HM-LP 4/11 (36.4%), 20/400 to CF 3/11 (27.3%), better than 20/400 3/11 (27.3%). The final VA significantly improved compared to presenting visual acuity (p<0.01). There was no statistical difference in final VA between GP vs. GN vs. fungal isolates.

Conclusions : Patients with endophthalmitis after PKP generally had poor visual outcomes. The causative organism were predominantly GP bacteria (82%).

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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