Presumed endophthalmitis following Boston keratoprosthesis treated with 25 gauge vitrectomy: a report of three cases.

Background: Although endophthalmitis is known to occur frequently in patients with KPros, the management remains a challenge both due to the lack of evidence and the exceptionality of the examination and the therapeutic approach.

Materials And Methods: Three patients implanted with Boston keratoprosthesis for management of ocular cicatricial pemphigoid and severe alkali injury presented with severe late-onset (10-24 months post-operatively), presumed bacterial endophthalmitis. Three-port 25-gauge (g) pars plana vitrectomy was performed in all patients; vitreous samples were acquired and intravitreal vancomycin and cefuroxime were administered.

Results: Post-operative outcome was significantly improved in all three cases. Visual acuity improved from perception of light (PL) to 20/400 in the first, PL to counting fingers in the second and PL to 20/400 in the third patient.

Conclusion: We present our experience from managing presumed bacterial endophthalmitis with 25 g PPV in patients previously implanted with Boston Kpro, which to the best of our knowledge has not been reported before. Although the number of cases is small to draw accurate conclusions, we have to report that 25 g vitrectomy was performed without significant difficulties and seems to be a useful tool for the management of patients with Kpros requiring vitreoretinal surgery.