The Faricimab Real-World Evidence (FARWIDE) studies are evaluating real-world outcomes of eyes with neovascular age-related macular degeneration (nAMD) or diabetic macular oedema (DMO) treated with faricimab in the UK. Here, we present results from FARWIDE-nAMD for eyes with 12 months of follow-up after faricimab initiation. nAMD patient-eyes that received ≥1 faricimab injection after May 2022 at one of 35 participating UK National Health Service retinal clinics with ≥12 months of follow-up after faricimab initiation as of July 2024 were included. Treatment-naïve (TN) eyes had no prior anti-VEGF treatment. Previously treated (PT) eyes switched from an anti-VEGF to faricimab. Baseline characteristics, VA, and injection frequency were assessed. Intraocular inflammation (IOI) and presumed infectious endophthalmitis (PIE) rates were pooled for nAMD and DMO eyes with any follow-up duration on faricimab. Analyses are descriptive. 5854 nAMD patients (6991 eyes; 26.5% TN, 73.5% PT) were included. 83.3% of PT eyes switched from aflibercept 2.0 mg. TN eyes received a mean (SD) of 4.7 (0.7) faricimab injections in months 1-6 and 2.2 (1.1) injections in months 7-12. PT eyes received 4.5 (1.0) injections in months 1-6 and 3.0 (1.2) in months 7-12. In TN eyes, mean (SD) VA increased from 56.4 (16.3) Early Treatment Diabetic Retinopathy Study letters at baseline to 60.1 (19.4) at 12 months (mean [SD] change 3.6 [14.7] letters). PT eyes had stable VA. IOI and PIE rates were consistent with faricimab phase 3 trials. These 1-year data support real-world faricimab effectiveness, durability, and safety in nAMD.

Intraocular inflammation (IOI) is a rare but potentially sight-threatening complication that can occur after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. This adverse event has been under scrutiny in recent years due to an increased incidence, particularly with some of the newer anti-VEGF agents, such as Brolucizumab. Faricimab is a new anti-VEGF medication that has been approved by the United States Food and Drug Administration. As it is relatively new on the market, long-term safety data is still being collected. This is a retrospective case series of 8 eyes in 5 patients with IOI that occurred after faricimab intravitreal injections. All patients were diagnosed with significant uveitis with anterior vitreous involvement and 4 out of the 5 patients presented subacutely with high intraocular pressure while the remaining patient presented acutely within 4 days following IVT with normal intraocular pressure. The patients received, on average, 4.875 faricimab injections prior to development of IOI and the inflammation resolved in all patients following cessation of faricimab injections and initiation of oral and topical non-steroidal anti-inflammatory agents and topical steroids. Non-infectious hypertensive uveitis can occur subacutely after intravitreal faricimab injections. It is imperative that intraocular pressure is promptly managed to reduce the risk of permanent glaucomatous damage. As all our patients presented with anterior vitreous involvement, it is also practical that such cases of IOI are not mistaken for infectious exogenous endophthalmitis to avoid unnecessary treatment with intravitreal antibiotics and surgery.

AimResearch on pediatric ocular trauma remains limited, and clinical management is often extrapolated from adult data. This study aimed to analyze the risk factors, visual prognosis, and microbiological characteristics of infectious endophthalmitis following pediatric ocular trauma, thereby providing evidence for clinical decision-making.MethodsA retrospective cohort study was conducted on 108 hospitalized children with ocular trauma treated at Hebei Eye Hospital between January 2019 and June 2025. Three parallel analyses were performed within the same population: (1) 54 children (54 eyes) with post-traumatic infectious endophthalmitis (endophthalmitis group) were matched to 54 children (54 eyes) without endophthalmitis (control group). Clinical features and inflammatory markers were compared, and risk factors were identified using receiver operating characteristic (ROC) curves and logistic regression; (2) patients were categorized into good-vision (55 cases) and poor-vision (33 cases) groups. Baseline data and inflammatory indices were compared to classify independent risk factors for poor visual outcome; and (3) pathogen culture and antibiotic susceptibility results were summarized.ResultsA total of 108 children were included, of whom 83 (76.85%) were male and 98 (90.74%) were rural residents. Risk factors for post-traumatic infectious endophthalmitis included delayed presentation, elevated white blood cell count (WBC), neutrophils (NEUT), monocytes (MON), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII) (OR = 0.979, 1.413, 1.29, 51.404, 166.58, 2.019, and 1.001, respectively). WBC (OR = 1.404) was identified as an independent risk factor. WBC presented good diagnostic performance with an AUC of 0.722; combined predictors improved the AUC to 0.745. Risk factors for poor visual prognosis included endophthalmitis, lens injury, elevated WBC, and elevated NEUT (OR = 4.667, 6.176, 1.152, and 1.15, respectively), with a combined AUC of 0.732. Among culture-positive cases in the endophthalmitis group, bacterial infection predominated (81.48%, 22/27). Gram-positive cocci were most common, primarily Staphylococcus and Streptococcus species, with broad susceptibility to cephalosporins, penicillin, vancomycin, aminoglycosides, and fluoroquinolones.ConclusionPediatric traumatic infectious endophthalmitis predominantly occurs in male children from rural areas. WBC is a valuable diagnostic biomarker, and the combination of multiple inflammatory indices further improves diagnostic accuracy. Delayed medical consultation is a critical risk factor. Patients with less severe lens damage and lower inflammatory marker levels are more likely to achieve favorable visual outcomes. Bacterial infections, especially Gram-positive cocci, are the predominant pathogens.

Mihe (MIOK) KPro with auricular cartilage reinforcement in end-stage corneal blindness: An open-label, nonrandomized trial

AimTo compare the surgical outcomes and assess the effectiveness of a three‐dimensional digital visualization system (3DVS) versus traditional microscope–assisted pars plana vitrectomy in the management of infectious endophthalmitis.MethodsA retrospective case series study was conducted on 29 patients diagnosed with infectious endophthalmitis who underwent 23‐gauge transconjunctival vitrectomy between 1 Jan. 2020 and 31 Aug. 2023. Of all these patients, 16 cases underwent vitrectomy‐assisted by the 3DVS (3D group), and the other 13 cases by traditional microscope (eyepiece group). The main comparison focuses on the differences between the two systems in terms of operation time, the brightness of the endoillumination, complications, and preoperative and final best‐corrected visual acuity (BCVA, logMAR).ResultsThere were no significant differences in baseline characteristics between the two groups, with trauma being the most prevalent cause of infection (10 vs 8). The positive detection rate of pathogenic bacteria exceeded 40% in both groups (43.75% vs. 46.15%). The results showed that the incidence of complications, including high intraocular pressure (3 vs. 4) and retinal detachment (4 vs. 3), did not differ significantly between the groups (chi‐square = 0.2857, p = 0.5930). The mean operation time was slightly shorter in the 3D group (75.94 ± 25.70 min) compared to the eyepiece group (82.31 ± 25.38 min, p = 0.5102). However, the 3D group exhibited significantly lower endoillumination (25%–35%) than the eyepiece group (40%–50%, p < 0.0001). Both groups demonstrated significant improvement in BCVA at the end of follow‐up (p = 0.0006, t = 4.321). The mean final BCVA for the 3D group was 1.373 ± 0.9824 logMAR, which was modestly superior to the eyepiece group’s mean of 1.805 ± 0.9549 logMAR.ConclusionThe 3DVS provides comparable surgical outcomes to the traditional microscope, with the advantages of clearer intraoperative visualization, lower required illumination, and optimized ergonomic design. It is suitable for complex and prolonged endophthalmitis surgery, offering excellent safety and efficacy.

Infectious endophthalmitis after ocular surgery is a rare complication that can result in severe vision loss. Moraxella nonliquefaciens is an opportunistic pathogen that rarely causes ocular infections. We report a rare case of Moraxella nonliquefaciens endophthalmitis complicated by secondary angle-closure glaucoma occurring years after trabeculectomy and cataract surgery. Cycloplegia resulted in deepening of the anterior chamber and opening of the angles. Metagenomic next-generation sequencing of the aqueous humor identified Moraxella nonliquefaciens. Following multiple intravitreal vancomycin injections and vitrectomy with posterior capsulectomy, direct communication between the anterior chamber and the vitreous cavity was established, leading to resolution of the condition. The patient’s visual acuity was fully restored. We hypothesize that persistent infection with Moraxella nonliquefaciens may damage the lens zonules, resulting in zonular laxity and weakness; however, this represents only one possible mechanistic explanation and may play a secondary role in the development of secondary angle-closure glaucoma. Ophthalmologists should be aware that patients with Moraxella nonliquefaciens endophthalmitis may be at risk of zonular laxity and secondary angle-closure glaucoma, particularly years after trabeculectomy and cataract surgery. Prompt recognition and intervention may be vision-saving.

To report five cases of postoperative sterile endophthalmitis in patients who underwent pars plana vitrectomy with silicone oil injection for retinal detachment. Review of the medical records of five patients who underwent pars plana vitrectomy with silicone oil injection at Southend University Hospital and the Royal Eye Infirmary, Derriford Hospital, University Plymouth Hospitals NHS Trust, for rhegmatogenous or tractional retinal detachment. All five patients presented with signs of anterior chamber inflammation exhibiting flare, fibrin, and hypopyon in the early or late postoperative period following vitrectomy with silicone oil injection. Treatment with topical antibiotics and steroids was began, with rapid resolution of the anterior chamber inflammatory reaction and no further intervention required. The use of silicone oil as a tamponade agent for retinal detachment can rarely induce sterile anterior chamber inflammation with signs resembling infectious endophthalmitis. Onset of symptoms, absence of pain, and good response to topical steroids can help differentiate between the two entities.

To analyze the incidence and clinical characteristics of acute infectious endophthalmitis after approximately 2.03 million cataract surgeries in 448 hospitals in China over a 5-year period (2017–2021). Retrospective, multi-center, cross-sectional study. Eyes developing acute infectious endophthalmitis after 2,026,416 cataract surgeries in 448 Aier eye hospitals in Mainland China from January 2017 to December 2021 were collected, and surgical methods and intraocular lens (IOL) types of the patients were analyzed. There was no prophylactic antibiotic administered routinely in the anterior chamber at the end of the cataract procedures.The conjunctival capsule was disinfected with 5% povidone iodine during surgery for at least 3 min.The incidence of postoperative acute infectious endophthalmitis was studied. Data such as operation time; hospital level; patient general condition; eye conditions; endophthalmitis onset time; and symptoms, diagnosis, treatment, and prognosis of visual acuity were analyzed. From 2017 to 2021, Aier eye hospitals in Mainland China completed 2,026,416 cataract surgeries, with 328 eyes developing acute infectious endophthalmitis—an overall incidence of 0.0162% in 5 years. A statistically significant difference in the incidence of endophthalmitis was observed among the four IOL implantation groups (PMMA, Foldable, Aspheric, and Premium IOLs) (p = 0.004). The PMMA IOL group had the highest incidence (0.0215%), compared to Foldable (0.0135%), Aspheric (0.0154%), and Premium IOLs (0.0212%).There was no statistically significant difference in the incidence among the different months, surgical procedures, and hospital levels. The mean age of patients with endophthalmitis was 70.73 ± 10.42 years. The average time of onset of endophthalmitis was 6.64 ± 6.46 days, with 78.35% of patients developing endophthalmitis within 7 days. The microbial culture positive rate of eye specimens was 17.21% in 42 cases, with Staphylococcus epidermidis (33.33%) having the highest detection rate. Visual acuity improved significantly following endophthalmitis treatment. The incidence of acute infectious endophthalmitis after approximately 2.03 million cataract surgeries in 448 Aier eye hospitals in China from 2017 to 2021 remained at low rate. Early discovery, diagnosis, and treatment are crucial to improve the visual prognosis of patients with endophthalmitis through analysis of influencing factors and clinical characteristics.

BackgroundThis study aimed to evaluate the role of Sanger sequencing in the early diagnosis of infectious endophthalmitis and compare its diagnostic yield with conventional microbiological methods.MethodologyA prospective pilot study was conducted at a tertiary eye care center over a period of one year, including 11 patients with clinically suspected endophthalmitis. Vitreous samples were subjected to Gram staining, KOH wet mount, and aerobic/fungal culture. Parallel molecular testing was performed using 16S rRNA PCR and Sanger sequencing. Diagnostic yield, turnaround time, and clinical relevance were compared.ResultsGram stain and KOH wet mount were positive in 1/11 (9.1%) cases each, while cultures were sterile in 9/11 (81.8%) and showed contaminants in 2/11 (18.2%). PCR amplification succeeded in 6/11 (54.5%) samples, with Sanger sequencing identifying Achromobacter (one case) and Bacillus spp. (three cases). Overall, molecular diagnostics established a likely bacterial etiology in 6/11 (54.5%) patients. Sequencing provided results within 24-48 hours, versus 5-7 days for culture.ConclusionsSanger sequencing significantly improved diagnostic yield and reduced turnaround time compared with conventional techniques. Although not a replacement for culture, it represents a valuable adjunct in managing culture-negative endophthalmitis. Larger multicentric studies are warranted to validate its routine clinical role.

Patient: Male, 52-year-oldFinal Diagnosis: Endogenous endophthalmitis • group G streptococcus bacteremia • infective endocarditis • meningitisSymptoms: FeverClinical Procedure: —Specialty: Infectious DiseasesObjective: Rare coexistence of disease or pathologyBackgroundGroup G streptococcus (GGS), primarily Streptococcus dysgalactiae subsp. equisimilis, is a commensal organism found on the skin, oropharynx, and the gastrointestinal and female genital tracts, often associated with superficial infections such as pharyngitis and cellulitis. Recent epidemiological trends indicate an increase in invasive GGS infection. While isolated cases have been reported, to our knowledge, this is the first reported case involving the simultaneous occurrence of infective endocarditis, endogenous endophthalmitis, and meningitis caused by GGS.Case ReportA 53-year-old man with a history of the Bentall procedure presented with 2 days of fever, slightly decreased consciousness, and ocular symptoms. He subsequently developed bilateral endogenous endophthalmitis and bacterial meningitis, both of which were diagnosed promptly through ophthalmologic examination and cerebrospinal fluid analysis. Blood cultures identified GGS, and he was treated with ampicillin 2 g every 4 hours. Blood cultures became negative on hospital day 4, after which he completed 8 weeks of antibiotics. He underwent vitrectomy and intravitreal antibiotics, which led to visual recovery in his right eye. Despite an initial echocardiogram that did not detect vegetations, gallium scintigraphy revealed signs of prosthetic valve endocarditis. His condition improved, and he was discharged on hospital day 66.ConclusionsThis case underscores the potential for GGS to cause severe, multisystem invasive disease and highlights the importance of early recognition and comprehensive management. Further research is needed to better understand the epidemiology, develop diagnostic strategies, and prevent invasive GGS infections.

To compare the ocular safety of intravitreal aflibercept injections and faricimab using population-based, global postmarketing data in a large pharmacovigilance study. Population-based, retrospective pharmacovigilance study. Patients for whom ocular adverse event (AE) reports were submitted to the US Food and Drug Administration Adverse Event Reporting System (FAERS) between January 2004 and June 2025 and for whom intravitreal aflibercept injections (2 or 8 mg, where dose was recorded) or faricimab were listed as the primary suspect drug were included. After deduplication, disproportionality was assessed using reporting odds ratios (RORs, 95% confidence interval). Safety signals were considered statistically significant if they met Evans criteria (ROR > 2, χ2 > 4, n ≥ 3), Bonferroni-adjusted P < 0.0003, and Bayesian threshold lower bound of the Bayesian information component (IC025) >0. Disproportionality signals for ocular AEs associated with intravitreal aflibercept 2 mg, aflibercept 8 mg, and faricimab, using aflibercept 2 mg as the reference comparator, given its longer market availability and well-established safety profile. Among 13 809 873 FAERS reports, 30 761 involved intravitreal aflibercept 2 mg (n = 21 058), aflibercept 8 mg (n = 727), or faricimab (n = 8976). After deduplication, 8352 reports remained for aflibercept 2 mg, 327 for aflibercept 8 mg, 4168 for faricimab, and 13 797 026 for other drugs. Most patients were aged 65 to 85 years; women comprised 48.6% of the 8 mg group, 39.9% of faricimab, and 20.8% of the 2 mg group. Aflibercept 8 mg showed the highest disproportionality for intraocular inflammation and infection-related events, including anterior chamber flare (ROR = 1410.5), vitritis (853.3), retinal vasculitis (352.2), infectious (1208.3), and sterile endophthalmitis (352.0), as well as blindness (71.1) and reduced visual acuity (74.6). Faricimab had the highest RORs for injection-related inflammatory and hemorrhagic events-hypopyon (112.8), retinal pigment epithelial tear (193.9), choroidal hemorrhage (142.3), and pseudoendophthalmitis (309.9)-whereas aflibercept 2 mg was more often associated with structural complications, including increased intraocular pressure (187.8), posterior capsule rupture (80.1), vitreous hemorrhage (76.9), and retinal detachment (20.8). All signals met Bonferroni-adjusted significance (P < 0.0001) and Bayesian criteria (IC025 > 0). Aflibercept 8 mg showed strong signals for intraocular inflammation, vasculitis, and endophthalmitis, aflibercept 2 mg was linked to structural complications, and faricimab had the highest disproportionality for select immunovascular events. These findings delineate agent- and dose-specific safety profiles within a unified comparative framework and reinforce the critical need for ongoing postmarketing surveillance. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

ObjectivePostoperative infectious endophthalmitis is a serious complication of cataract surgery. Understanding its risk factors, pathogen distribution, and related biomarkers is crucial for prevention and treatment. This study aimed to investigate the risk factors for postoperative infectious endophthalmitis following cataract surgery, analyze pathogen types, and evaluate the correlation between changes in peripheral blood levels of IL-17, MMP-2, and IGF-1 and the occurrence of this complication.MethodsIn this retrospective observational cohort study, 784 patients (1568 eyes) who underwent cataract surgery at Changzhi People’s Hospital Eye Hospital from January 2020 to June 2024. Aqueous humor and vitreous fluid were collected from patients with postoperative infectious endophthalmitis for pathogen culture. Basic clinical data of infected and non-infected groups were compared, and differences in serum concentrations of IL-17, MMP-2, and IGF-1 three days after surgery were analyzed to assess the predictive ability of these biomarkers for infectious endophthalmitis.ResultsAmong the 784 surgical cases, 46 eyes from 42 patients were diagnosed with infectious endophthalmitis, including 38 cases of unilateral infection (38 patients with one infected eye each) and 4 cases of bilateral infection (4 patients with both eyes infected).Pathogen culture results showed that Gram-positive bacteria were the predominant pathogens (accounting for 73.08%). Univariate and multivariate analyses revealed that diabetes mellitus and vitreous spillage were independent risk factors for postoperative infectious endophthalmitis after cataract surgery. Further analysis of serum biomarkers revealed that serum levels of IL-17 and MMP-2 in the infected group were significantly higher, while IGF-1 was significantly lower than those in the non-infected group three days after surgery (all P < 0.05). Receiver operating characteristic curve analysis indicated that the combined detection of these three biomarkers had a high predictive efficacy for postoperative infectious endophthalmitis after cataract surgery, with an area under the curve of 0.955, a sensitivity of 95.27%, and a specificity of 82.42%.ConclusionAlthough the incidence of postoperative infectious endophthalmitis after cataract surgery is low, the presence of diabetes mellitus and vitreous spillage significantly increases the risk. Gram-positive bacteria are the main pathogens. Changes in serum levels of IL-17, MMP-2, and IGF-1 are closely related to the occurrence of infectious endophthalmitis, and the combined detection of these three biomarkers has high predictive value, providing an important reference for early clinical identification and intervention.

To describe a new "corneal gap bridging technique" (CGBT) used in eyes requiring a penetrating keratoplasty (PKP) with a trephination diameter >8.0 mm combined with a pars plana vitrectomy (PPV) to allow for the effective application for otherwise unsuitable standard keratoprostheses. A proof-of-concept study in 2 eyes undergoing combined PKP and PPV with corneal gap bridging technique at a tertiary university hospital. The first patient was an 88-year-old woman with infectious keratitis endophthalmitis and the second was a 34-year-old man with peripheral corneal melting and retinal detachment with subretinal proliferative vitreoretinal membrane. An Eckardt-keratoprosthesis was implanted into a donor's corneoscleral disc unsuitable for permanent transplantation because of scarring or reduced endothelial cell counts. After trephination of the host cornea, the disc is fixed to the recipient sclera with interrupted sutures, allowing optimal visualization of the posterior segment during PPV through the now centered keratoprosthesis. After PPV, the disc and prosthesis are removed, and the permanent corneal donor tissue is transplanted as in PKP. At the last follow-up, both eyes showed a clear graft with attached retina and no signs of recurrent infection. The Homburger corneal bridging technique is a viable option to use the benefits of temporary keratoprostheses in eyes requiring a large-diameter PKP with combined PPV. The disc fixation is easy to perform as in PKP without a new learning curve. Further studies are needed to determine whether the improved visualization provided by this approach translates into better long-term functional and anatomical outcomes in eyes with complex pathologies.

Endophthalmitis requiring multiple ocular tissue sampling for microbiological testing is uncommon and has not been previously studied. This study aims to analyse cases with at least two ocular tissue samplings and testing of different ocular samples against culture yields. A 27-year prospective observational study using data from the Victorian Endophthalmitis Registry, managed through the REDCap data platform. The study included 314 patients (317 eyes) who underwent at least two aqueous or vitreous specimen collections. The primary outcome measures included microbiological culture results from repeat and multiple intraocular samples and identification of isolated microorganisms. The overall initial culture positivity rate was 75.7%, while the culture positivity rate at the second intervention was 34.7%. First vitreous taps had the highest culture yield (72.6%) among different sample types. Notably, 19.5% of eyes with initial negative vitreous cultures had subsequent positive results. Further analysis showed that 24.4% of eyes with initial negative vitreous cultures had corresponding positive aqueous cultures. Additionally, 12.2% of eyes with negative initial vitreous taps yielded positive cultures from vitreous biopsies or washings from vitrectomy. Staphylococcus and Streptococcus species were the main pathogens isolated (40.4% and 31.3% of cases respectively). Our study demonstrated the trends and utility of repeated and different ocular tissue sampling in challenging endophthalmitis. Aqueous taps are most useful at the first biopsy, beyond which it has little diagnostic value. A second sampling can be valuable in patients who are initially culture-negative. Surgical specimens contribute meaningfully to the overall culture yield and enhance cumulative culture positivity.

Acute pofl-cataract infectious endophthalmitis is a rare yet serious complicationthat can lead to significant intraocular inflammation and potential loss of vision following cataract surgery. Early diagnosis and prompt treatment are essential to prevent irreversible damage to photoreceptors. While the Early Vitrectomy Study (EVS) provided initial treatment guidelines, clinical approaches have since evolved. In this observational, retrospective single-center study at Biratnagar Eye Hospital, we analyzed data from patients diagnosed with presumed endophthalmitis within six weeks of cataract surgery in 2023. All patients received intravitreal antibiotics (vancomycin and ceftazidime) and underwent tap biopsy for microbiological analysis. Data included demographics, clinical features, treatment (intravitreal antibiotics ± vitrectomy), and visual acuity (LogMAR) at baseline and 60 days. The data were recorded in Excel and analyzed using Statical Package for the Social Sciences version 29.0 (IBM Corp., Armonk, NY, USA). The study found that 44 (87.70%) were between 40-80 years old, with males 28 (57.14%). Symptoms appeared primarily within the firfl two weeks pofl-surgery in 31 (62%) of cases. Phacoemulsification 24 (48%) and Small Incision Cataract Surgery 26 (52%) were represented in the patient population. Out of total patients,44 (88%) of the patients received only intravitreal antibiotics. A notable improvement was observed in visual acuity with mean Log MAR values decreasing from 1.395± 0.632 on Day 1 (Snellen equivalent 6/120) to 0.441±0.553 on Day 60 (Snellen equivalent 6/15). No notable variations in visual acuity was observed in age, gender, surgical technique (phacoemulsification vs. SICS), or adjunctive dexamethasone. Findings suggefled that early therapeutic intervention with intravitreal antibiotics in acute pofloperative endophthalmitis may improve visual outcomes when evaluated at 60 days pofl-treatment.

The goals of this study was to analyze and explore the effect of comprehensive sensory control strategy on prevention and control of infectious endophthalmitis after cataract surgery. From January 2012 to December 2023, a study of patients with infectious endophthalmitis after cataract surgery was conducted in a hospital. Perioperative infection prevention measures include topical eye drops, lacrimal irrigation, povidone iodine disinfection of conjunctival sac, etc. After in-depth investigation and analysis of the reasons for the increase in the incidence of endophthalmitis for three times, a series of effective prevention and control measures were proposed for the root causes of the problems, including optimizing the key link system, implementing closed-loop management of sensory control measures, designing personalized children's surgery plan, strengthening perioperative treatment, comprehensively monitoring the operating room clean system, strengthening the cleaning and disinfection treatment between consecutive operations to ensure the safety of the operating environment, etc. RESULTS: From January 2012 to December 2023, a total of 134,045 cataract operations were performed, of which 26 cases were infected at the surgical site, with an infection rate of 0.019%. According to the specific infection characteristics of each period, corresponding prevention and control measures were formulated and implemented, which significantly reduced the incidence of endophthalmitis (P < 0.01). In 2012, 2016 and 2020, the incidence of endophthalmitis was 0.057%, 0.048% and 0.029%, respectively, showing a linear decreasing trend, which was statistically significant (X2 = 19.793, P ≤ 0.01). By analyzing the characteristics of infectious endophthalmitis in different periods, the main causes can be inferred, and the prevention and control measures can be explored to effectively reduce the incidence of infectious endophthalmitis after cataract surgery.

To report 12-month results from the GALE open-label extension study (NCT04770545), evaluating up to 36 months of intravitreal pegcetacoplan treatment for geographic atrophy (GA) in age-related macular degeneration (AMD). GALE is a prospective open-label extension study following the 24-month, sham-controlled, phase 3 OAKS (NCT03525613) and DERBY (NCT03525600) studies of pegcetacoplan. Patients with nonsubfoveal or subfoveal GA who completed OAKS, DERBY, or phase 1b APL2-103 (NCT03777332) studies. Pegcetacoplan was administered monthly (PM) or every other month (PEOM) to all study eyes in GALE. Eyes receiving pegcetacoplan in OAKS and DERBY continued the same regimen (PM-PM and PEOM-PEOM), while eyes observed with sham in OAKS and DERBY crossed over to receive pegcetacoplan at the same dosing interval in GALE (SM-PM and SEOM-PEOM). Safety and efficacy through the first 12 months of GALE were assessed, reflecting up to 36 months of continuous pegcetacoplan treatment. Mean rate of change in GA area, total number of microperimetry scotomatous points, and adverse events. Through the first 12 months of GALE, 92.0% (727/790) patient retention was observed. Across all eyes, including eyes with nonsubfoveal and subfoveal GA, pegcetacoplan reduced the mean rate of change in GA area up to 32% versus projected sham. Year after year, the reductions in the mean rate of change in GA area increased, with up to a 42% reduction observed in eyes with nonsubfoveal GA in the PM-PM group compared with projected sham in the first year of GALE. An 18% reduction in new scotomatous points (P = .0156) was observed with PM-PM at 36 months, highlighting a significant impact in a prespecified microperimetry analysis. Adverse events included 33 (4.5%) eyes with exudative AMD, 15 (1.9%) intraocular inflammation (classified as mild or moderate in severity), 1 (0.1%) ischemic optic neuropathy, and 1 (0.1%) infectious endophthalmitis. No events of vasculitis were reported. Over 36 months, pegcetacoplan continued to reduce GA growth with increasing efficacy over time and reduced formation of new scotomatous points. The safety profile of pegcetacoplan in the first 12 months of GALE was consistent with the prior 24-month OAKS and DERBY studies.

Background/Objectives: Infectious endophthalmitis is a vision-threatening complication of intraocular surgery and intravitreal injections. Standard treatment involves intravitreal antibiotics; however, concerns regarding multidrug resistance and vancomycin-associated hemorrhagic occlusive retinal vasculitis (HORV) highlight the need for alternative antimicrobial strategies. This study aimed to evaluate the clinical efficacy and safety of a protocol combining intravitreal injection of 1.25% povidone-iodine (PI) with intraoperative irrigation using low concentrations of vancomycin and ceftazidime. Methods: We retrospectively analyzed 11 eyes from patients diagnosed with postoperative or injection-related endophthalmitis. Six of the eleven cases received an initial intravitreal injection of 1.25% PI, followed by pars plana vitrectomy with irrigation using balanced salt solution PLUS containing vancomycin (20 μg/mL) and ceftazidime (40 μg/mL). A second intravitreal PI injection was administered at the end of surgery in all cases. Additional PI injections were administered postoperatively based on clinical response. Clinical outcomes included best-corrected visual acuity (BCVA), microbial culture results, corneal endothelial cell density, and visual field testing. Results: All eyes achieved complete infection resolution without recurrence. The mean BCVA improved significantly from 2.18 logMAR at baseline to 0.296 logMAR at final follow-up (p < 0.001). No adverse events were observed on specular microscopy or visual field assessment. The protocol was well tolerated, and repeated PI injections showed no signs of ocular toxicity. Conclusions: This combination protocol provides a safe and effective treatment strategy for infectious endophthalmitis. It enables rapid and complete infection resolution while minimizing the risks associated with intravitreal antibiotics. These findings support further investigation of this protocol as a practical and globally accessible alternative to standard intravitreal antimicrobial therapy.

Intravitreal injections have revolutionized the treatment of retinal diseases, yet there are possible complications, such as noninfectious intraocular inflammation, a complication that may threaten vision and mimic infectious endophthalmitis. This review synthesizes current knowledge on inflammation after intravitreal therapy, with particular focus on sterile intraocular inflammation and retinal vasculitis associated with anti-VEGF agents such as brolucizumab and newer complement inhibitors like pegcetacoplan. The pathogenesis is multifactorial, involving patient-specific immune responses, drug-specific properties including aggregation or impurities, and deviations in preparation or delivery techniques. Clinical presentations range from anterior uveitis and vitritis to occlusive retinal vasculitis. Visual outcomes vary and depend on prompt recognition and appropriate management. Epidemiologic data show variable incidence across agents, with brolucizumab demonstrating higher rates of inflammation compared with ranibizumab or aflibercept. Treatment includes corticosteroids and discontinuation of the offending agent, with rare cases requiring surgical intervention. As the therapeutic landscape expands, heightened awareness and standardized evaluation of postinjection inflammation are critical to improving safety and preserving vision.

The most common etiology of infectious endophthalmitis is usually bacterial or fungal. The main ways of infection penetration into the eyeball: exogenous (trauma, complication of surgical intervention on the eyeball) or endogenous (dissemination of infection in septic processes, hematogenous spread). The most common pathogens of mycotic endophthalmitis are Candida spp., Aspergillus spp. and Fusarium spp. Diagnosis of fungal processes is labor-intensive and not always available. Often, patients undergo long-term treatment before perfect diagnosis. Ethiotropic treatment includes the use of antimycotic druds and surgical methods. The article presents a clinical observation of a long-term course of mycotic endophthalmitis caused by Fusarium spp. with an outcome in spontaneous perforation of the eyeball. Keywords: Fusarium spp.; antimycotic therapy; voriconazole; posaconazole; mycotic endophthalmitis; fusarium; endophthalmitis