Purpose: 

To describe the presentation, microbiology, management, and prognosis of eyes with endophthalmitis after Boston keratoprosthesis implantation.

Methods: 

Retrospective case series with history, diagnostics, management, and outcomes data in endophthalmitis after keratoprosthesis implantation presenting to a tertiary center between 2009 and 2020.

Results: 

Of 137 keratoprosthesis-implanted eyes, 7 eyes of 7 patients (5%) developed endophthalmitis. On presentation, 6 (86%) reported decreased visual acuity, and only 1 (14%) reported pain. Peripheral corneal ulcers were present in 2 eyes (29%). Seidel testing was negative in all cases. Six eyes (86%) had retroprosthetic membranes. One (14%) underwent initial pars plana vitrectomy with mechanical vitreous biopsy, whereas 6 (86%) received a needle vitreous tap—half of which were dry. Organisms were isolated after vitreous tap in two eyes: Streptococcus intermedius and Mycobacterium abscessus. The mean visual acuity preendophthalmitis, at presentation, and at 6 months were 20/267, 20/5,944, and 20/734, respectively. The visual acuity improved 9.08 ± 11.78 Early Treatment Diabetic Retinopathy Study lines from presentation to 6 months. Six-month visual acuity was correlated with preendophthalmitis visual acuity (r = 0.92, P = 0.003) but not presenting visual acuity (P = 0.838).

Conclusion: 

Visual acuity at 6 months is correlated with preendophthalmitis visual acuity, not presenting visual acuity. Endophthalmitis should be considered in the differential diagnosis of painless intraocular inflammation any time after keratoprosthesis implantation, even if Seidel negative.

中文翻译：

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人工角膜移植后眼内炎的临床特征和视觉结果

目的： 

描述波士顿人工角膜植入术后眼内炎的表现、微生物学、管理和预后。

方法： 

回顾性病例系列，包括 2009 年至 2020 年间在一家三级中心的人工角膜移植后眼内炎的病史、诊断、管理和结果数据。

结果： 

在 137 只人工角膜移植眼中，7 名患者（5%）的 7 只眼出现眼内炎。就诊时，6 人 (86%) 报告视力下降，只有 1 人 (14%) 报告疼痛。2 只眼（29%）出现外周角膜溃疡。在所有情况下，赛德尔测试均为阴性。六只眼睛 (86%) 有假体后膜。1 名 (14%) 接受了初始玻璃体切除术和机械玻璃体活检，而 6 名 (86%) 接受了针状玻璃体穿刺——其中一半是干燥的。在两只眼睛的玻璃体抽吸后分离出生物体：中间链球菌和脓肿分枝杆菌。眼内炎前、就诊时和 6 个月时的平均视力分别为 20/267、20/5,944 和 20/734。这从呈现到 6 个月，视力提高了 9.08 ± 11.78 早期治疗糖尿病视网膜病变研究线。六个月视力与眼内炎前视力相关（r = 0.92，P = 0.003），但不呈现视力（P = 0.838）。

结论： 

6个月视力与眼内炎前视力相关，不呈现视力。在人工角膜移植后的任何时候，即使 Seidel 阴性，在无痛性眼内炎症的鉴别诊断中也应考虑眼内炎。