Two Cases of Klebsiella Pneumoniae Endogenous Endophthalmitis Treated with Sulperazone

PURPOSE: To report and review 2 cases of Klebsiella Pneumoniae endogenous endophthalmitis showing multi drug resistance that were treated with sulperazone. METHODS: Sulperazone was administered to two patients with Klebsiella Pneumoniae endogenous endophthalmitis: a 51-year-old male with orbital cellulitis who showed no response to vancomycin, ceftazidime, and amikacin for 6days; and a 67-year-old female who showed no response to cefotaxime, and amikacin. RESULTS: Proptosis and inflammation began to improve after changing to sulperazone. Therefore, enucleation and debridement could be avoided. CONCLUSIONS: Good results were obtained by use of Sulperazone which inactivates beta-lactamase irreversibly and which showed bactericidal effect to multi drug resistant Klebsiella Pneumoniae endogenous endophthalmitis.

The Change in Deviation Angle with Time Course after Surgical Correction of Intermittent Exotropia

PURPOSE: To evaluate the amount and pattern of change in deviation angle with time course after surgical correction of intermittent exotropia and to evaluate the effect of pre-operative deviation and operation age on post-operative deviation change. METHODS: 54 patients who followed more than 60 months (60~120 months, mean 71.7 months) after surgical correction of intermittent exotropia were selected. We defined 'satisfactory results' that alignment of orthotropia, under 10delta esotropia and under 10delta exotropia. RESULTS: Of 54 patients, satisfactory results obtained in 96.2%(52 patients), immediate post-operation day and decreas with time course to 35.1% (19 patients) at post-operative 5 years. To quantification of change of deviation, author defined exotropic drift as +, esotropic drift as -, and no change as 0. The change of deviation between immediate post-operation and 2 years after operation is +14.55delta, between 2 years after and 5 years is +2.70delta. The change of deviation developed between immediate post-operation and 2 years after operation has statistical significance in comparison with change of deviation developed between after 2 years and 5 years after operation (P=0.0001). Pre-operative deviation has no effect on post-operative deviation change (P=0.4472) and operation age was same (P=0.3461). CONCLUSIONS: The results of surgical correction of intermittent exotropia is significantly deteriorated with time course. Exotropic drift was more pronounced between immediate post-operation and 2 years after operation and then decreased. Therefore we recommend that after surgery of intermittent exotropia patients should be followed by schedule more than 2 years and thereafter the tendency for exotropic drift will more stable. After 2 years, however, small amount exotropic drift can be possible.

A Case of Pneumocephalus Following Facial Trauma Pneumocephalus

PURPOSE: To describe a patient who developed left subconjunctival air and pneumocephalus without definite finding of skull fracture after facial trauma. METHODS: A 16-year-old man developed headache, upper eyelid swelling and decreased visual acuity after facial trauma. Ophthalmic examinations revealed left subconjunctival hemorrhage, air and corneal abrasion. Computed tomography and simple X-ray showed huge orbital emphsema. It extends into the left posterior sclera, around the optic nerve and optic canal. Diagnosis of pneumocephalus of basal cistern with no bony fracture of face, orbits and skull was made. RESULTS: In clinical practice, physician should be kept in mind that the possibility of pneumocephalus resulted from orbital or subconjunctival emphysema through optic nerve sheath in case of no definite evidence of basal skull fractures.