Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/81216
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dc.contributor.authorKonstantopoulos, Arisen
dc.contributor.authorTan, Xiao Weien
dc.contributor.authorGoh, Gwendoline Tze Weien
dc.contributor.authorSaraswathi, Padmanabhanen
dc.contributor.authorChen, Liyanen
dc.contributor.authorNyein, Chan Lwinen
dc.contributor.authorZhou, Leien
dc.contributor.authorBeuerman, Rogeren
dc.contributor.authorTan, Donald Tiang Hweeen
dc.contributor.authorMehta, Jodhbir Singhen
dc.contributor.editorMohan, Rajiv R.en
dc.date.accessioned2015-12-18T06:26:29Zen
dc.date.accessioned2019-12-06T14:23:51Z-
dc.date.available2015-12-18T06:26:29Zen
dc.date.available2019-12-06T14:23:51Z-
dc.date.issued2015en
dc.identifier.citationKonstantopoulos, A., Tan, X. W., Goh, G. T. W., Saraswathi, P., Chen, L., Nyein, C. L., et al. (2015). Prophylactic Vancomycin Drops Reduce the Severity of Early Bacterial Keratitis in Keratoprosthesis. PLoS ONE, 10(10), e0139653-.en
dc.identifier.issn1932-6203en
dc.identifier.urihttps://hdl.handle.net/10356/81216-
dc.description.abstractBackground: Artificial cornea transplantation, keratoprosthesis, improves vision for patients at high risk of failure with human cadaveric cornea. However, post-operative infection can cause visual loss and implant extrusion in 3.2–17% of eyes. Long-term vancomycin drops are recommended following keratoprosthesis to prevent bacterial keratitis. Evidence, though, in support of this practice is poor. We investigated whether prophylactic vancomycin drops prevented bacterial keratitis in an animal keratoprosthesis model. Methodology: Twenty-three rabbits were assigned either to a prophylactic group (n = 13) that received vancomycin 1.4% drops 5 times/day from keratoprosthesis implantation to sacrifice, or a non-prophylactic group (n = 10) that received no drops. All rabbits had Staphylococcus aureus inoculation into the cornea at 7–12 days post-implantation and were sacrificed at predetermined time-points. Prophylactic and non-prophylactic groups were compared with slit-lamp photography (SLP), anterior segment optical coherence tomography (AS-OCT), and histology, immunohistochemistry and bacterial quantification of excised corneas. Corneal vancomycin pharmacokinetics were studied in 8 additional rabbits. Results: On day 1 post-inoculation, the median SLP score and mean±SEM AS-OCT corneal thickness (CT) were greater in the non-prophylactic than the prophylactic group (11 vs. 1, p = 0.049 and 486.9±61.2 vs. 327.4±37.1 μm, p = 0.029 respectively). On days 2 and 4, SLP scores and CT were not significantly different. Immunohistochemistry showed a greater CD11b+ve/non-CD11b+ve cell ratio in the non-prophylactic group (1.45 vs. 0.71) on day 2. Bacterial counts were not significantly different between the two groups. Corneal vancomycin concentration (2.835±0.383 μg/ml) exceeded minimum inhibitory concentration (MIC) for Staphylococcus aureus only after 16 days of vancomycin drops. Two of 3 rabbits still developed infection despite bacterial inoculation after 16 days of prophylactic drops. Conclusions: Prophylactic vancomycin drops provided short-term benefit, but did not prevent infection. Achieving MIC in the cornea was not sufficient to prevent Staphylococcus aureus keratitis. Patients should continue to be counselled regarding the risk of infection following keratoprosthesis.en
dc.description.sponsorshipNRF (Natl Research Foundation, S’pore)en
dc.format.extent13 p.en
dc.language.isoenen
dc.relation.ispartofseriesPLoS ONEen
dc.rights© 2015 Konstantopoulos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en
dc.subjectEye infectionsen
dc.titleProphylactic Vancomycin Drops Reduce the Severity of Early Bacterial Keratitis in Keratoprosthesisen
dc.typeJournal Articleen
dc.contributor.schoolSchool of Materials Science & Engineeringen
dc.identifier.doi10.1371/journal.pone.0139653en
dc.description.versionPublished versionen
dc.identifier.pmid26460791-
item.fulltextWith Fulltext-
item.grantfulltextopen-
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