Infectious keratitis in patients undergoing Boston Type 1 keratoprosthesis (Boston KPro) procedure: case series

Nascimento, Heloísa; Oliveira, Lauro Augusto de; Höfling-Lima, Ana Luísa

doi:10.1590/s0004-27492011000200012

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2015

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Cited by 5 publications

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“…17 Reports originating from developing countries were scarce and consisted mostly of case series from Brazil and India. 13–14, 20 Causative organisms included both yeasts ( Candida albicans, Candida parapsilosis, Candida glabrata, Candida famata ) and molds ( Fusarium spp., Aspergillus spp., Alternaria spp. ).…”

Section: Resultsmentioning

confidence: 99%

Fungal Infections After Boston Type 1 Keratoprosthesis Implantation

Odorcic

Haas

Gilmore

et al. 2015

Cornea

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Purpose To review the current literature describing cases of fungal keratitis and endophthalmitis following Boston Keratoprosthesis (KPro) implantation, and characterize the antifungal activity of 0.01% hypochlorous acid against medically relevant fungi. Methods A literature review of fungal keratitis or endophthalmitis in KPro patients from January 2001 to April 2015, and an in vitro time kill assay characterizing the fungicidal activity of 0.01% hypochlorous acid against fungi causing ocular infections. Results Fifteen publications, predominantly retrospective case series, were identified. Infection rates following KPro implantation ranged from 0.009–0.02 fungal infections per patient-year of follow-up. The largest single surgeon series reported an incidence of 2.4% for fungal endophthalmitis during a 10-year period. Causative organisms included both yeasts and molds. Outcomes were favorable if infections were caught early and treated appropriately; less favorable outcomes were reported in developing countries where fungal species are endemic and resources limited. 0.01% hypochlorous acid is rapidly fungicidal, reducing the number of viable yeast cells or mold conidia by at least 99.99% within 60 seconds. The antifungal activity extended to all molds (Acremonium kiliense, Aspergillus flavus, Aspergillus fumigatus, Fusarium solani, Mucor indicus) and yeast species (Candida albicans, Candida parapsilosis) tested. Conclusions Fungal infections remain a lifelong concern in patients following KPro implantation. There is a growing need for a standard antifungal prophylaxis regimen, especially in the developing world. The rapid broad-spectrum in vitro fungicidal activity of 0.01% hypochlorous acid against all fungi tested makes it an attractive candidate as an antifungal prophylaxis in KPro patients.

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Infectious keratitis in patients undergoing Boston Type 1 keratoprosthesis (Boston KPro) procedure: case series

Cited by 5 publications

References 5 publications

Fungal Infections After Boston Type 1 Keratoprosthesis Implantation

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