title: Fungal Infections in Boston Keratoprosthesis Patients: Lessons Learned and Novel Developments on the Horizon.
abstract: The Boston Keratoprosthesis (B-KPro) is a widely accepted modality of corneal restoration in eyes where traditional penetrating keratoplasty has little chance of success. It is the most commonly used keratoprosthesis worldwide. While the introduction of broad-spectrum antibiotic prophylaxis has virtually eliminated cases of bacterial endophthalmitis, fungal colonization and infections are a growing concern. This review of the literature summarizes risk factors for fungal infections in KPro eyes, rates of fungal infection and colonization, clinical presentation, causative organisms, management, and outcomes. We also focus on current recommendations for antifungal prophylaxis, and highlight the role of translational research at the Massachusetts Eye and Ear Infirmary (MEEI, Boston, USA) with its aim of developing novel strategies for reducing rates of fungal infections in KPro patients.
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
authors.forename: Silvia
authors.initials: S
authors.lastname: Odorcic
authors.affiliation: b Department of Ophthalmology , University of Ottawa Eye Institute, The Ottawa Hospital , Ottawa , Ontario , Canada , and.
authors.forename: Saama
authors.initials: S
authors.lastname: Sabeti
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Haas
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .|c Department of Medicine , Massachusetts General Hospital , Boston , Massachusetts , USA.
authors.forename: Marlene L
authors.initials: ML
authors.lastname: Durand
authors.affiliation: a Department of Ophthalmology , Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
authors.forename: Claes H
authors.initials: CH
authors.lastname: Dohlman
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001705:Bioprosthesis / Q000382:microbiology*; D003320:Corneal Ulcer / Q000382:microbiology* / Q000517:prevention & control; D009877:Endophthalmitis / Q000382:microbiology* / Q000517:prevention & control; D015821:Eye Infections, Fungal / Q000382:microbiology* / Q000517:prevention & control; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D009181:Mycoses / Q000382:microbiology* / Q000517:prevention & control; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents
keywords: Endophthalmitis; keratitis; mold; prophylaxis; translational research; yeast