Post-cataract Endophthalmitis Research Articles

Current management strategies of acute post-operative endophthalmitis

The current management of acute post-operative endophthalmitis relies on microbial confirmation, intravitreal antibiotics, and vitrectomy. The endophthalmitis vitrectomy study (EVS) demonstrated that systemic antibiotics are not necessary in post-cataract/secondary intraocular lens (IOL) acute bacterial endophthalmitis, and that vitrectomy could be required only for eyes with presenting vision of light perception. Since the publication of the EVS newer tests are available for microbial confirmation, and many new and effective antibiotics are discovered for systemic therapy. We have studied large numbers of patients with endophthalmitis over several years. Perhaps our experience represents the endophthalmitis status in the developing countries. The article is a synthesis of recent publications in the world literature. Finally the authors have suggested a management strategy for acute post-cataract acute bacterial endophthalmitis.

Current management strategies of acute post-operative endophthalmitis

The current management of acute post-operative endophthalmitis relies on microbial confirmation, intravitreal antibiotics, and vitrectomy. The endophthalmitis vitrectomy study (EVS) demonstrated that systemic antibiotics are not necessary in post-cataract/secondary intraocular lens (IOL) acute bacterial endophthalmitis, and that vitrectomy could be required only for eyes with presenting vision of light perception. Since the publication of the EVS newer tests are available for microbial confirmation, and many new and effective antibiotics are discovered for systemic therapy. We have studied large numbers of patients with endophthalmitis over several years. Perhaps our experience represents the endophthalmitis status in the developing countries. The article is a synthesis of recent publications in the world literature. Finally the authors have suggested a management strategy for acute post-cataract acute bacterial endophthalmitis.

Effect of vancomycin on Staphylococcus epidermidis adherence to poly(methyl methacrylate) intraocular lenses

Purpose: To study the adherence of Staphylococcus epidermidis in variable loads (10 8 cfu/mL and 10 3 cfu/mL) to poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) and to evaluate the effect of vancomycin treatment on S epidermidis adherence to the IOL. Setting: L.V. Prasad Eye Institute, Hyderabad, India. Methods: The study was designed in 2 parts. Phase I: Twelve PMMA IOLs were soaked in a solution of S epidermidis, randomized to 10 8 cfu/mL or 10 3 cfu/mL. They were rinsed or rinsed and vortexed and cultured. Phase II: Twelve IOLs were treated with vancomycin (10 mg/mL), randomized to before and after treatment with S epidermidis. Results: Staphylococcus epidermidis adhered to all portions of the IOL with 10 8 cfu/mL and 10 3 cfu/mL bacterial loads. Treatment with vancomycin reduced S epidermidis adherence. Conclusion: Pretreatment of an IOL with vancomycin or a suitable antibiotic agent appears to reduce bacterial adherence to the IOL. Placement of a sustained-release device that could release an antibiotic agent over a specific period, reducing the incidence of postcataract endophthalmitis, should be studied.

Endophthalmitis following cataract surgery.

This article is an attempt to review the latest advances in recognition, treatment, and prevention of postcataract extraction endophthalmitis.

Recurrent Enterococcal Endophthalmitis Following Cataract Surgery: A Case Report

Recurrent post-cataract endophthalmitis is a well-recognized postoperative complication that has been attributed to various organisms and different mechanisms. To our knowledge, there is no case of recurrent postoperative endophthalmitis reported where the organism was found to be sequestered in the posterior capsule, escaping total eradication and thus producing the recurrence. The following is a case report of such recurrent postoperative endophthalmitis caused by Enterococcus faecalis sequestered in the posterior capsule.

Decreased Gentamicin Dose

To the Editor —.In the article, Treatment of Post-Cataract Bacterial Endophthalmitis With Periocular and Systemic Antibiotics and Corticosteroids. (Trans Am Acad Ophthalmol Otol81:151-162, 1976), we suggested the systemic administration of gentamicin sulfate at a dosage of 5 mg/ kg/day in three divided doses over a 24-hour period in patients with normal renal function, even though nephrotoxic and ototoxic effects may occur at this high dose level. This schedule approximates the maximal dosage for a 24-hour period and is suggested for patients with life-threatening disease. We have used this therapeutic schedule in our series of patients in combination with daily periocular injections of 40 mg of gentamicin sulfate and have encountered no untoward renal effects. However, since a periocular injection of gentamicin adds to the total systemic dose and since many patients treated for bacterial endophthalmitis are elderly and may, therefore, have a slightly decreased creatinine clearance, despite a normal