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Keratoprosthesis prophylaxis: is it time for a paradigm shift?

Authors Pelletier JS, Barone SB, Capriotti JA

Received 28 June 2018

Accepted for publication 16 August 2018

Published 12 September 2018 Volume 2018:12 Pages 1785—1788


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

JS Pelletier,1–3 SB Barone,1 JA Capriotii1,2

1Department of Ophthalmology, Veloce BioPharma LLC, Fort Lauderdale, FL, USA; 2Department of Ophthalmology, Plessen Ophthalmology Consultants, Christiansted, VI, USA; 3Department of Ophthalmology, Ocean Ophthalmology Group, Miami, FL, USA

Abstract: The Boston Type I Keratoprosthesis has been improving in both design and safety since its inception. Due to particular features inherent in the Boston Type I Keratoprosthesis eye and certain aspects of the ocular surface, special attention is required to maintain these implanted devices. There is currently a prominent role for keratoprosthesis prophylaxis; it is designed to prevent infectious complications like keratitis and endophthalmitis. This standard-of-care therapy has anecdotally been shown to improve outcomes; however, it has not been examined in the setting of controlled clinical trials. Moreover, concerns remain with the chronic utilization of topical antibiotics in that they may engender antibiotic resistance and select for opportunistic populations to establish a foothold on the ocular surface. We believe and introduce the idea that there is merit in exploring other compounds besides antibiotics for prophylaxis such as antiseptics like povidone-iodine. Specifically developed formulations of povidone-iodine may prove useful in both improving keratoprosthesis safety and simultaneously mitigating concerns regarding antibiotic resistance.

Keywords: keratoprosthesis, ocular surface, povidone-iodine, antimicrobial resistance

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