Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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).
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.
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.
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.
This PDF is available to Subscribers Only