Inflammation & Infection

Pre-soaked IOLs may provide an excellent way to deliver fourth-generation fluoroquinolones to prevent endophthalmitis.

Acanthamoeba is a ubiquitous, free-living protozoan that rarely causes ocular disease other than troublesome keratitis.1-5 It remains restricted to the cornea, either because the trophozoites cannot penetrate Descemet's membrane and the corneal endothelium in order to enter the anterior chamber (AC), or the trophozoites are able to enter the anterior chamber but the cells of the innate immune apparatus prevent it from progressing to cause an intraocular infection.

At the ESCRS congress in September, Peter Barry presented the full ESCRS endophthalmitis study results and controversially stated that, not only is the incidence of endophthalmitis higher than reported in the literature, but the risk of infection is further increased by clear corneal incisions and the use of silicon IOLs.

Ophthalmology is a branch of medicine that we, as ophthalmologists, regard as an elite branch of medicine and others, such as general surgeons and physicians, often consider as a minor and sometimes easy discipline. As a result of this misdirected preconception, a general practitioner, consultant or physician may not feel it necessary to fully inform us of a patient's health record because they do not consider that ophthalmic medications could, potentially, carry with them serious, sometimes life threatening side effects, if used inappropriately.

First described in 1881 by Litten 1 and attributed to Albert Terson, a French ophthalmologist who later described it in 1900, 2 Terson's syndrome is a condition defined as vitreous haemorrhage occurring in association with a subdural or subarachnoid haemorrhage (SAH). Here, Bastawrous and his team of colleagues describe a patient with Terson's syndrome and subsequent Candida endophthalmitis.

Postoperative endophthalmitis is a rare but potentially devastating intraocular infection, which could lead to severe and permanent visual impairment or even the loss of an eye.1-3 With the average life expectancy on the increase, the prevalence of cataract in the older population and therefore the cataract surgical rate has increased in recent decades.1,3 Many have voiced their concerns that this rise in the number of surgical procedures could bring with it a rise in incidence of endophthalmitis, hence, evaluation of postoperative infection incidence is extremely important in every clinical setting.

Results of a study evaluating post-cataract surgery endophthalmitis at a regional tertiary referral centre in England show no evidence of an increase in incidence over a recent period of almost eight years, reported Omar M. Durrani, FRCS.