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Endophthalmitis prophylaxis

Rohan Merani, Zachary E McPherson, Alan P Luckie, Jagjit S Gilhotra, Jim Runciman, Shane Durkin, James Muecke, Mark Donaldson, Albert Aralar, Anupam Rao, Peter E Davies
PURPOSE: To determine the incidence of endophthalmitis in a large clinical series using aqueous chlorhexidine for antisepsis before intravitreal injection and to review the ophthalmic literature regarding chlorhexidine efficacy and safety. DESIGN: Multicenter retrospective case series. PARTICIPANTS: All patients receiving intravitreal injections from 7 retinal specialists. METHODS: An audit of intravitreal injections performed by retinal specialists who exclusively used aqueous chlorhexidine 0...
October 6, 2016: Ophthalmology
Charles Mesnard, Laurence Beral, Rabih Hage, Harold Merle, Selim Farès, Thierry David
PURPOSE: To report a case series of post-phacoemulsification endophthalmitis despite antibiotic prophylaxis with an intracameral injection of a licensed cefuroxime formulation (Aprokam). SETTING: University Hospitals of Pointe-à-Pitre, Guadeloupe, and Fort-de-France, Martinique, French West Indies. DESIGN: Retrospective case series. METHODS: Patients who had cataract surgery with licensed cefuroxime prophylaxis between March 1, 2013, and July 31, 2015, and developed endophthalmitis were included...
September 2016: Journal of Cataract and Refractive Surgery
Sergio Piscitello, Maria Vadalà
Prevention of postoperative endophthalmitis (POE) is a goal of every ophthalmic procedure and also in intravitreal therapy (IVT). This comparative retrospective study targets whether systemic and topical preoperative antibiotic prophylaxis (PAP) regimen does prevent POE after IVT in a higher rate compared with topical PAP alone. Out of 6111 IVT performed over a period of 103.5 months, in the study group A patients were treated with systemic and topical PAP (2881 IVT), and in the study group B patients were treated only with topical PAP (3230 IVT)...
September 1, 2016: International Ophthalmology
Hesam Hashemian, Reza Mirshahi, Mehdi Khodaparast, Mahmoud Jabbarvand
PURPOSE: To investigate recent evidence in prophylaxis and management of post-cataract surgery endophthalmitis. METHODS: We conducted a literature search using Pubmed database for post cataract surgery endophthalmitis, and relevant articles were selected from original English papers published since 2015. RESULTS: Forty-nine articles were published regarding post-cataract surgery endophthalmitis from January 2015 to February 2016. A low incidence of post-cataract surgery endophthalmitis has been reported...
September 2016: Journal of Current Ophthalmology
Bobeck S Modjtahedi, Tavé van Zyl, Hemang K Pandya, Robert E Leonard, Dean Eliott
PURPOSE: To present cases of endophthalmitis following intravitreal injections where povidone-iodine (PI) was not used as part of the surgical preparation. DESIGN: Retrospective case series. METHODS: All cases of presumed injection-related endophthalmitis presenting to the Massachusetts Eye and Ear Infirmary between June 2008 and November 2014 and Dean McGee Eye Institute between January 2010 and January 2015 were identified. Patients who did not receive PI preparation owing to documented self-reported allergy to iodine, iodine-containing contrast material, or shellfish were identified and their injection histories and clinical courses reviewed...
October 2016: American Journal of Ophthalmology
Jason M Huang, Andrew D Pansick, Preston H Blomquist
PURPOSE: The choice and route of antibiotic prophylaxis in the setting of open globe injury remains controversial. We investigated the utility of intravenous vancomycin and cefepime prophylaxis in preventing endopthalmitis after open globe injury. METHODS: The charts of 224 patients who presented to Parkland Memorial Hospital and Children's Medical Center in Dallas, Texas, between June 1, 2009 and June 30, 2013, with open globe injury and who were treated with prophylactic intravenous vancomycin and cefepime were retrospectively reviewed...
September 2016: Journal of Ocular Pharmacology and Therapeutics
Cheryl Py Au, Andrew Jr White, Paul R Healey
BACKGROUND: Endophthalmitis is a rare but devastating postoperative complication of cataract surgery. We aimed to describe the incidence of acute postoperative endophthalmitis in an Australian population over a 14-year period. DESIGN: This was a retrospective longitudinal cohort study performed at Westmead Hospital, a major tertiary hospital in Sydney, Australia. PARTICIPANTS: Patients who had acute postoperative endophthalmitis within 6 weeks of their cataract surgery at Westmead Hospital were included...
June 17, 2016: Clinical & Experimental Ophthalmology
Bingsheng Lou, Lixia Lin, Junlian Tan, Yao Yang, Zhaohui Yuan, Xiaofeng Lin
PURPOSE: To elucidate the Chinese practice of intraocular antibiotics administration for prophylaxis after open globe injury. METHODS: A cross-sectional questionnaire survey was performed online by scanning a Quickmark (QR) code with smartphones at the 20th Chinese National Conference of Ocular Trauma in November 2014. RESULTS: A total of 153 (30.6%) of all participators at the conference responded. Of the respondents, 20.9% were routinely administered with prophylactic intraocular injection of antibiotics at the conclusion of the primary eye repair, and 56...
2016: PloS One
Cédric Benoist d'Azy, Bruno Pereira, Geraldine Naughton, Frédéric Chiambaretta, Frédéric Dutheil
Despite endophthalmitis being the most feared complication, antibioprophylaxis remains controversial in intravitreal injections. Therefore, we conducted a systematic review and meta-analysis on the effects of antibioprophylaxis in intravitreal injections in the prevention of endophthalmitis. The PubMed, Cochrane Library, Embase and Science Direct databases were searched for studies comparing groups with and without antibiotics in intravitreal injection, with the use of the following keywords: "antibiotic*", "endophthalmitis" and "intravitreal injection*"...
2016: PloS One
Silvia Odorcic, Saama Sabeti, Wolfgang Haas, Marlene L Durand, Claes H Dohlman
The Boston Keratoprosthesis (B-KPro) is a widely accepted modality of corneal restoration in eyes where traditional penetrating keratoplasty has little chance of success. It is the most commonly used keratoprosthesis worldwide. While the introduction of broad-spectrum antibiotic prophylaxis has virtually eliminated cases of bacterial endophthalmitis, fungal colonization and infections are a growing concern. This review of the literature summarizes risk factors for fungal infections in KPro eyes, rates of fungal infection and colonization, clinical presentation, causative organisms, management, and outcomes...
2016: Seminars in Ophthalmology
Nicholas Jones, Tomaz Garcez, William Newman, David Denning
A 25-year-old woman presented with unilateral red eye and visual blur, and was found to have panuveitis with an inflammatory white mass at the macula, initially presumed to be Toxoplasma retinitis. After failure to respond, she underwent vitrectomy, which produced Candida albicans. Despite intraocular and systemic antifungal treatment, she lost all vision in that eye. Two years later, she developed unilateral hip osteomyelitis leading to total hip replacement and also revealing Candida infection. By clinical exome sequencing, she was then found to have caspase recruitment domain 9 (CARD9) deficiency, an autosomal recessive disorder that causes a specific susceptibility to candidal infections...
2016: BMJ Case Reports
Paris Tranos, Nikolaos Dervenis, Athanasios N Vakalis, Solon Asteriadis, Panagiotis Stavrakas, Anastasios G P Konstas
Endophthalmitis is an intraocular inflammatory condition which may or may not be caused by infective agents. Noninfectious (sterile) endophthalmitis may be attributable to various causes including postoperative retained soft lens matter or toxicity following introduction of other agents into the eye. Infectious endophthalmitis is further subdivided into endogenous and exogenous. In endogenous endophthalmitis there is hematogenous spread of organisms from a distant source of infection whereas in exogenous endophthalmitis direct microbial inoculation may occur usually following ocular surgery or penetrating eye injury with or without intraocular foreign bodies...
May 2016: Advances in Therapy
K H Eibl-Lindner, C Wertheimer, A Kampik
Development of an intraocular lens (IOL) as a drug delivery device has been pursued for many years and is a promising concept in modern cataract surgery. Common postoperative conditions such as posterior capsule opacification (PCO), intraocular inflammation or the rare but severe complications of cataract surgery like endophthalmitis are potential therapeutic targets for a drug-eluting IOL. There are three techniques of pharmacological IOL modification: Firstly, surface modification of the IOL ("coating"); secondly, IOL optic modification ("soaking") and lastly, loading the IOL haptics with a slow release system...
February 2016: Klinische Monatsblätter Für Augenheilkunde
Stephen G Schwartz, Andrzej Grzybowski, Harry W Flynn
Endophthalmitis remains a rare but important cause of visual loss. Prophylaxis strategies are important to reduce rates of endophthalmitis after cataract surgery, intravitreal injection, and other procedures. There is substantial variability between the US and the rest of the world. During cataract surgery, intracameral antibiotics are commonly used in many nations, especially in Europe, but are less commonly used in the US. A randomized clinical trial from the European Society of Cataract and Refractive Surgeons reported an approximately fivefold reduction in endophthalmitis rates associated with intracameral cefuroxime but these results are controversial...
2016: Clinical Ophthalmology
Jay J Meyer, Philip Polkinghorne, Charles Nj McGhee
No abstract text is available yet for this article.
February 4, 2016: Clinical & Experimental Ophthalmology
Anders Behndig, Beatrice Cochener-Lamard, José Güell, Laurent Kodjikian, Rita Mencucci, Rudy Nuijts, Uwe Pleyer, Paul Rosen, Jacek Szaflik, Marie-Jose Tassignon
PURPOSE: To report the results from the first iteration of the European Observatory of Cataract Surgery, which was initiated to track changes in surgical, antiseptic, and antibiotic practices in cataract surgery over the coming years. SETTING: Practicing European cataract surgeons (n = 479). DESIGN: Internet-based declarative questionnaire or telephone questionnaire. METHODS: The questionnaire comprised 37 questions divided into 8 categories as follows: screening, surgeon profile, surgical procedure used, product use before arrival at the operating room, techniques for mydriasis and anesthesia, product use during the surgery, product use after the patient leaves the operating room, and surgeon's attitude to guidelines...
December 2015: Journal of Cataract and Refractive Surgery
Ama Sadaka, Marlene L Durand, Robert Sisk, Michael S Gilmore
PURPOSE: To review antibiotic resistance associated with S. aureus endophthalmitis and the virulence of S. aureus. METHODS: Review of the current and prospective approaches for treating S. aureus endophthalmitis. RESULTS: Bacterial endophthalmitis remains to be a major threat for vision. S. aureus endophthalmitis specifically, carries a poor visual prognosis making early diagnosis and treatment crucial. Methicillin resistant Staphylococcus aureus (MRSA) endophthalmitis represents a significant number of S...
December 17, 2015: Ocular Immunology and Inflammation
Alexa L Li, Charles C Wykoff, Rui Wang, Eric Chen, Matthew S Benz, Richard H Fish, Tien P Wong, James C Major, David M Brown, Amy C Schefler, Rosa Y Kim, Ronan E OʼMalley
PURPOSE: To determine the rate of postintravitreal injection endophthalmitis and to assess microbiological features and outcomes with and without the use of peri-intravitreal injection topical ophthalmic antibiotics. METHODS: Consecutive series of endophthalmitis cases retrospectively identified after intravitreal injection at a multicenter, retina-only referral practice (Retina Consultants of Houston) from January 1, 2011 to December 31, 2014. Prophylactic peri-intravitreal injection topical antibiotics were routinely used during the initial 12-month period (January 1, 2011-December 31, 2011) and not used in the final 24-month period (January 1, 2013-December 31, 2014)...
July 2016: Retina
Timothy Y Y Lai, Shu Liu, Sudipta Das, Dennis S C Lam
Intravitreal (IVT) injection of therapeutic agents has become one of the most commonly performed procedures in ophthalmology. Over the past decade, a number of guidelines have been published that recommend proper techniques to increase the safety of IVT injections. Among the various complications of IVT injections, endophthalmitis can be sight threatening. The reported endophthalmitis rates after IVT injection range from 0.020% to 0.085%, which are higher than what would be expected from a simple, fast, and relatively atraumatic procedure...
November 2015: Asia-Pacific Journal of Ophthalmology
Monika Lazicka-Gałecka, Tomasz Gałecki, Jacek P Szaflik
Levofloxacin 0.5% ophthalmic solution is a fluoroquinolone antibacterial agent with a broad spectrum of activity against Gram positive and negative bacteria. For those reasons it is highly effective in treating common external infections of the eye including blepharitis, conjunctivitis, keratitis. In terms of microbial eradication and clinical cure rate it is significantly more effective than ofloxacin 0.3% ophthalmic solution, and non inferior to moxifloxacin ophthalmic solution. After topical administration of levofloxacin 0...
2015: Klinika Oczna
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