Value of Cultures Before Operation for Cataract

Dunnington, John H.; Locatcher-Khorazo, D.

doi:10.1001/archopht.1945.00890190215007

Cited by 49 publications

(5 citation statements)

References 5 publications

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“…The increased risk of infection following inferior trabeculectomy is believed to be due in part to pooling of the bacteria-rich tear film 16 . The tear film is known to harbor organisms capable of causing endophthalmitis 17 . Inferior drainage device exposure creates a conduit for host flora to pass into the eye.…”

Section: Discussionmentioning

confidence: 99%

Glaucoma Drainage Devices: Risk of Exposure and Infection

Levinson

Giangiacomo

Beck

et al. 2015

American Journal of Ophthalmology

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Purpose To identify risk factors for device exposure and intraocular infection following implantation of a glaucoma drainage device. Design Retrospective case series. Methods The medical records of adult patients undergoing glaucoma drainage device implantation at an academic medical center between 2000–2010 were reviewed. Main outcome measures included device exposure and intraocular infection. Results Seven hundred and sixty-three cases were identified. These included 702 primary implants (ie. the first drainage device implanted into an eye) and 61 sequential implants. Among 702 primary implants, there were 41 (5.8%) cases of exposure. None of the potential risk factors were statistically significant. Implant location was found to be a marginally-significant risk factor. The exposure rates for inferior and superior implants were 12.8% (5 of 39) and 5.4% (36 of 663), respectively (P=0.056). The highest rate of exposure for primary implants occurred in the inferior-nasal quadrant (17.2%, 5 of 29). The rate of exposure for sequential devices was 13.1% (8 of 61) with the highest rate also found in the inferior-nasal quadrant (20%, 5 of 25). Of 49 total exposures, eight were associated with intraocular infection (16.3%). Exposures over inferior implants were more likely to be associated with infection than exposures over superior implants (41.7% vs 8.1%; P=0.0151). Conclusion Implant location approached, but did not reach, statistical significance as a risk factor for exposure. Exposures over inferior implants place patients at a higher risk of infection than superior exposures. More studies are needed to identify modifiable risk factors for device exposure.

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Section: Discussionmentioning

confidence: 99%

Glaucoma Drainage Devices: Risk of Exposure and Infection

Levinson

Giangiacomo

Beck

et al. 2015

American Journal of Ophthalmology

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“…). It is known that the tear film contains bacteria known to harbour organisms capable of causing endophthalmitis (Dunnington & Locatcher‐Khorazo ). In several retrospective case series studies, the incidence of inferior BRI was higher than that of the superior blebs, with incidence ranging from 1% to 19.2% (Wolner et al.…”

Section: Bri Risk Factorsmentioning

confidence: 99%

“…). It is believed that blebs in eyes that have had combined surgery are thicker than those having trabeculectomy alone (Dunnington & Locatcher‐Khorazo ; Greenfield et al. ).…”

Section: Bri Risk Factorsmentioning

confidence: 99%

Bleb‐related infection revisited: a literature review

Yassin

2015

Acta Ophthalmologica

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ABSTRACT. Bleb-related infection (BRI) is one of the serious complications of glaucoma filtering surgery. This literature review is aimed at the evaluation of recent studies related to BRI. The review presented and discussed risk factors, and clinical and laboratory diagnosis emphasizing advances in diagnostic techniques to detect and distinguish the disease as well as to initiate immediate intensive antibacterial treatment. Clinical features of recognized prognostic factors of visual outcome were also presented. The studies showed that the prognosis of blebitis is usually good, unless infection has progressed to endophthalmitis that would signify a poorer prognosis. Despite prompt and intensive treatment of patients with bleb-related endophthalmitis, the outcomes remain unsatisfactory especially with virulent organisms and low initial visual acuity. It has been recommended that early detection and treatment of risk factors and thorough patient education are indispensable in ensuring best prognosis in post-trabeculectomy patients.

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“…5 Less virulent organisms cause milder and later onset disease, which may respond to topical steroids, and are difficult to distinguish from persistent postoperative inflammation. 6 The ocular surface flora is capable of causing endophthalmitis [7][8][9] and is the likely source of infection in most cases. 10 11 Bacteria can enter the eye at the time of uncomplicated surgery, 11 12 and they can be cultured from the anterior chamber in higher numbers after ECCE than after phaco.…”

mentioning

confidence: 99%

A 10 year retrospective survey of cataract surgery and endophthalmitis in a single eye unit: injectable lenses lower the incidence of endophthalmitis

Mayer

Cadman²,

Ewings³

et al. 2003

British Journal of Ophthalmology

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Aim: To study the incidence of endophthalmitis following cataract surgery over a 10 year period, and to examine ways in which this may be related to changes in surgical technique. Methods: All cases of endophthalmitis occurring over a 10 year period within a single ophthalmic unit in the United Kingdom were reviewed, and possible risk factors identified. Results: During the study period, as the technique of extracapsular cataract surgery was replaced by phacoemulsification, there was a commensurate reduction in the incidence of endophthalmitis. Injectable IOLs were associated with the lowest risk of postoperative endophthalmitis (0.028%). Conclusions: Injectable intraocular lenses do not make contact with the ocular surface and this may result in the observed lower rate of endophthalmitis. This, and the ease with which they can be inserted through small incisions, support their use as the first line method of lens insertion.

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Value of Cultures Before Operation for Cataract

Cited by 49 publications

References 5 publications

Glaucoma Drainage Devices: Risk of Exposure and Infection

Glaucoma Drainage Devices: Risk of Exposure and Infection

Bleb‐related infection revisited: a literature review

A 10 year retrospective survey of cataract surgery and endophthalmitis in a single eye unit: injectable lenses lower the incidence of endophthalmitis

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