ArticleJournal of ophthalmic inflammation and infection2026
Culture-proven endophthalmitis associated with Boston Type I keratoprosthesis: clinical features, microbiologic aspects, and outcomes.
Article in Journal of ophthalmic inflammation and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo characterize the clinical presentation, management, and outcomes of culture-proven endophthalmitis associated with the surgical use of a Boston Type I keratoprosthesis (Boston I KPro).
methodsA retrospective consecutive case series was conducted of culture-positive cases of endophthalmitis associated with the surgical use of Boston I KPro at a single tertiary referral center. Data were collected on patient demographics, transplant history, presenting features, management strategies, and outcomes.
resultsInclusion criteria were met by 9 eyes of 9 patients. The mean age was 76 ± 3 years. At presentation, all eyes were on chronic topical antibiotic prophylaxis. Initial vision was hand motion or worse in 8/9 (89%) of eyes. Presumed etiologies included early postoperative infection in 3/10 (30%), corneal melt with leaks in 3/10 (30%), corneal ulcer without leaks in 3/10 (30%). Vitreous cultures identified gram-positive organisms in 7/9 (78%), including Staphylococcus aureus in 3, Streptococcus sp. in 3, coagulative-negative Staphylococcus in 1, Corynebacterium in 1 and Mycobacterium in 1. Vitrectomy was performed in 8/9 (89%) of eyes with 3 eyes undergoing removal of the Boston I KPro. Despite prompt treatment, visual outcomes were poor with best-corrected visual acuity at last follow-up averaging 20/1600 with 2 eyes achieving ≥ 20/200 vision. Enucleation or evisceration was performed in 2 eyes.
conclusionsCulture-proven endophthalmitis after Boston I KPro implantation is a rare, devastating complication. Patients present rapidly with severe vision loss. Management often includes prompt vitrectomy. Visual prognosis is guarded with most eyes having worse than 20/200 vision at last follow-up.
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