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Fernanda P. Magalhaes, Heloisa M. Nascimento, Ana L. Hofling-Lima, Lauro A. Oliveira; Post-operative Regimen of Boston Type I Keratoprosthesis with Topical 0.5% Moxifloxacin and 5% Povidone-iodine. Invest. Ophthalmol. Vis. Sci. 2011;52(14):347.
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Evaluate a prophylactic regimen of daily topical 0.5% moxifloxacin and 5% povidone-iodine (PI) on every regular visit in patients with Boston Type I Keratoprosthesis (Kpro). Evaluate the benefits of additional topical 5% PI to prevent infections.
Retrospective analysis of 31 patients with Boston Type I Keratoprosthesis on daily topical 0.5% moxifloxacin and 5% PI on regular visits. Prospective microbiologic surveillance of the inferior conjunctival fornix and of Kpro-donor cornea interface of 10 patients using topical 5% PI. Three scrapings (one before PI administration, one 30 minutes after, and one 7 days later) were collected in the inferior fornix and Kpro-donor cornea interface.
One in 31 (3.2%) patients developed bacterial keratitis (follow-up: 16.5 months; 3 - 29 months). Most of the cases there were no microorganism growth. The inferior fornix scraping was positive for coagulase negative staphylococcus (CNS) in two patients (20%) previously to PI administration, which were later negative in 30 minutes as well as 7 days later. The Kpro-donor cornea interface scraping was positive for CNS in one patient (10%), remained positive 30 minutes later, but was sterile 7 days after PI administration. There was a fungal growth in the kpro-donor cornea interface 30 minutes after PI administration which was negative 7 days later.
Topical 0.5% moxifloxacin associated with topical 5% PI on regular visits has been efficient as a prophylactic regimen in patients with Boston Type I Keratoprosthesis. Additional topical 5% PI seems to be effective reducing colonization of the inferior fornix and Kpro-donor cornea interface.
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