Nasolacrimal duct screening to minimize post‐cataract surgery endophthalmitis

Kam, Jonathan K; Cheng, Nicholas; Sarossy, Marc; Allen, Penelope J; Brooks, Anne M. V.

doi:10.1111/ceo.12244

Cited by 22 publications

(31 citation statements)

References 9 publications

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“…To control infection in intraocular surgery, it is important to consider that bacterial conjunctival flora may be changed among mild lacrimal duct obstruction patients without remarkable clinical findings. Kam et al 15 reported that the incidence of postcataract endophthalmitis among nasolacrimal duct obstruction patients was significantly higher than in the control group. Therefore, it is preferable to confirm the lacrimal duct obstruction prior to intraocular surgery regardless of epiphora.…”

Section: Discussionmentioning

confidence: 95%

Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients

Hoshi

Hashida

Urabe

2016

Eye

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Purpose To investigate the relationship between the background of preoperative cataract patients and bacterial conjunctival flora. Methods A total of 990 cataract patients who had completed preoperative examinations in 2007 and 2008 were included. Patients using topical antibiotics at the preoperative examination or having a history of intraocular surgery were excluded. Conjunctival cultures had been preoperatively obtained. Patient characteristics were investigated via medical records. Risk factors for conjunctival flora of seven typical bacteria were analyzed by univariate and multivariate analyses. Results The detection rate of alphahemolytic streptococci and Enterococcus faecalis increased with age (P = 0.044 and P = 0.002, respectively). The detection rate of Gram-negative bacilli was higher among patients with oral steroid use or lacrimal duct obstruction (P = 0.038 and P = 0.002, respectively). The detection rate of Corynebacterium species was higher among older patients and men, and lower among patients with glaucoma eye drop use (Po0.001, P = 0.012 and P = 0.001, respectively). The detection rate of methicillin-susceptible coagulase-negative Staphylococci was higher among men and lower among patients with a surgical history in other departments (P = 0.003 and P = 0.046, respectively). The detection rate of methicillin-resistant coagulase-negative Staphylococci (MR-CNS) was higher among patients with oral steroid use, a visit history to ophthalmic facilities, or a surgical history in other departments (P = 0.002, P = 0.037 and Po0.001, respectively). Conclusions Elderly patients, men, patients with lacrimal duct obstruction or immunosuppressed patients are more likely to be colonized by pathogens that cause postoperative endophthalmitis. Moreover, MR-CNS colonization was associated with healthcare-associated infection.

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Section: Discussionmentioning

confidence: 95%

Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients

Hoshi

Hashida

Urabe

2016

Eye

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“…Moreover, given the fact that older patients are natural candidates for various intraocular surgeries, it should be remembered that nontreatment of these types of pathologies may cause serious complications [1]. Therefore, it should be remembered that patients who consult specialists about these complaints have a very large etiological spectrum, their causes should be sought out, patients should be encouraged for cause-oriented treatment, and the necessary treatment should be implemented.…”

Section: Discussionmentioning

confidence: 99%

“…It causes much discomfort for patients in their daily lives and also puts the safety of several intraocular surgeries and surgical attempts at risk [1]. …”

Section: Introductionmentioning

confidence: 99%

How Important Is the Etiology in the Treatment of Epiphora?

Ulusoy

Kıvanç

Atakan

et al. 2016

Journal of Ophthalmology

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Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p = 0.012) and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients' comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.

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“…The medial canal wall is comprised of the lacrimal bone in its upper region and by the lacrimal process of the inferior nasal concha in its lower portion. Obstruction of the tear duct may cause epiphora and dacryocystitis [ 1 – 9 ] and has been associated with a greater risk of endophthalmitis following intraocular surgery [ 10 , 11 ]. The most frequent causes of secondary acquired obstruction are facial surgery, trauma, neoplasm, sarcoidosis, and Wegener granulomatosis [ 1 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Reconstruction of the Bony Nasolacrimal Canal by Automated Segmentation of Computed Tomography Images

et al. 2016

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ObjectiveTo apply a fully automated method to quantify the 3D structure of the bony nasolacrimal canal (NLC) from CT scans whereby the size and main morphometric characteristics of the canal can be determined.DesignCross-sectional study.Subjects36 eyes of 18 healthy individuals.MethodsUsing software designed to detect the boundaries of the NLC on CT images, 36 NLC reconstructions were prepared. These reconstructions were then used to calculate NLC volume. The NLC axis in each case was determined according to a polygonal model and to 2nd, 3rd and 4th degree polynomials. From these models, NLC sectional areas and length were determined. For each variable, descriptive statistics and normality tests (Kolmogorov-Smirnov and Shapiro-Wilk) were established.Main Outcome MeasuresTime for segmentation, NLC volume, axis, sectional areas and length.ResultsMean processing time was around 30 seconds for segmenting each canal. All the variables generated were normally distributed. Measurements obtained using the four models polygonal, 2nd, 3rd and 4th degree polynomial, respectively, were: mean canal length 14.74, 14.3, 14.80, and 15.03 mm; mean sectional area 15.15, 11.77, 11.43, and 11.56 mm2; minimum sectional area 8.69, 7.62, 7.40, and 7.19 mm2; and mean depth of minimum sectional area (craniocaudal) 7.85, 7.71, 8.19, and 8.08 mm.ConclusionThe method proposed automatically reconstructs the NLC on CT scans. Using these reconstructions, morphometric measurements can be calculated from NLC axis estimates based on polygonal and 2nd, 3rd and 4th polynomial models.

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Nasolacrimal duct screening to minimize post‐cataract surgery endophthalmitis

Cited by 22 publications

References 9 publications

Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients

Risk factors for aerobic bacterial conjunctival flora in preoperative cataract patients

How Important Is the Etiology in the Treatment of Epiphora?

Three-Dimensional Reconstruction of the Bony Nasolacrimal Canal by Automated Segmentation of Computed Tomography Images

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