Prophylactic Antibiotic Regimens in Keratoprosthesis

Abstract

Abstract: : Purpose: To reduce the risk of bacterial endophthalmitis in keratoprosthesis cases by improving on long-term prophylactic antiobiotic regimens. Methods: Two keratoprosthesis patient groups are compared based on their postoperative antibiotics regimen and incidence of endophthalmitis. The first group of 114 patients, operated between 1990 and 2002, and mostly previously published, had been prescribed postoperative drops of either ofloxacin 0.3% alone or polymyxin-B/trimethoprim alone, at least twice daily. The second new group, 76 patients, operated between 1999 and 2002, had received a combination of vancomycin (14mg/ml) and ofloxacin 0.3%, at least twice daily. The mix of preoperative diagnoses was approximately the same in both groups. Results: In the first group bacterial endophthalmitis occurred in thirteen cases sporadically within four years postoperatively (mean follow up time of patients was 3.4 years). In the second group there was no case of bacterial endophthalmitis (mean follow up time was 1.3 years). Conclusions: The addition of vancomycin drops prophylactically seems to markedly reduce the incidence of bacterial endophthalmitis following keratoprosthesis surgery.

Keywords: endophthalmitis • antibiotics/antifungals/antiparasitics • keratoprostheses