March 08, 2019
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Endophthalmitis more likely in PK vs EK cases

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PHILADELPHIA — Corneal transplant patients who underwent penetrating keratoplasty had higher rates of endophthalmitis than those who underwent endothelial keratoplasty, according to a study.

The retrospective chart review examined CPT and ICD codes from one Philadelphia practice to identify cases of endophthalmitis between April 1, 2012, and Aug. 31, 2018.

“The purpose of this study was to assess the rate of endophthalmitis following endothelial and penetrating keratoplasty and to also assess clinical outcomes following endophthalmitis after corneal transplantation and evaluate potential risk factors for this complication,” Durga S. Borkar, MD, said at the Wills Eye Conference.

A total of 16 endophthalmitis cases were identified from 3,968 corneal transplants.

“What we found is that the type of transplant was significant,” Borkar said.

Patients who had received penetrating keratoplasty were 3.5 times more likely to develop endophthalmitis compared with those who had received endothelial keratoplasty. In addition, there was a significant association between patients who received a concurrent vitrectomy, ether plans plana or anterior vitrectomy, and endophthalmitis.

The microbial spectrum for corneal transplant patients with endophthalmitis is also much broader than in post-injection or cataract surgery endophthalmitis, according to Borkar.

Rates of visual recovery following endophthalmitis was also worse in PK patients and rates of graft failure were higher.

“Endophthalmitis rates are significantly lower after EK compared to PK, although they are both pretty low,” Borkar said. – by Rebecca L. Forand

Reference:

Borkar D. Endophthalmitis rates and clinical outcomes following corneal transplantation. Presented at: Wills Eye Conference; March 7-9, 2019; Philadelphia.

Disclosure: Borkar reports no relevant financial disclosures.