ABSTRACT
PURPOSE: To report 4 cases of acute postoperative endophthalmitis (POE) after uneventful temporal clear corneal topical dropless cataract surgery involving intravitreal triamcinolone-moxifloxacin (TriMoxi). SETTING: Private practice in Peoria, IL, USA. DESIGN: Retrospective noncomparative case series. METHODS: Charts of patients presenting with POE after an uneventful temporal clear corneal phacoemulsification with in-the-bag implantation of a posterior chamber intraocular lens over a 15-month period were reviewed. RESULTS: Patients presented with typical signs and symptoms of acute POE 3 to 14 days after cataract surgery. The POE resolved after 25-gauge pars plana vitrectomy and injection of intravitreal vancomycin, ceftazidime, and dexamethasone. Two of 4 eyes were culture-positive for coagulase-negative Staphylococcus. The corrected distance visual acuity at the last follow-up visit was 20/40 or better in 3 eyes, and 20/400 in 1 eye because of underlying atrophic age-related macular degeneration. CONCLUSION: Postoperative endophthalmitis can occur after dropless cataract surgery with intravitreal triamcinolone-moxifloxacin.
Subject(s)
Endophthalmitis/etiology , Eye Infections, Bacterial/etiology , Moxifloxacin/adverse effects , Phacoemulsification/adverse effects , Surgical Wound Infection/etiology , Triamcinolone/adverse effects , Acute Disease , Aged , Aged, 80 and over , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/adverse effects , Drug Combinations , Endophthalmitis/diagnosis , Eye Infections, Bacterial/diagnosis , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Glucocorticoids/adverse effects , Humans , Intravitreal Injections/adverse effects , Male , Moxifloxacin/administration & dosage , Retrospective Studies , Surgical Wound Infection/diagnosis , Triamcinolone/administration & dosageABSTRACT
PURPOSE: To assess patient satisfaction and perceived outcomes with different methods of refractive error correction through annual surveys administered over a 3-year period. DESIGN: Prospective, longitudinal, parallel-group, multicenter survey. PARTICIPANTS: A total of 1800 subjects, aged 18 to 60 years, who had LASIK or continued using contact lenses. METHODS: Twenty sites across the United States enrolled subjects who completed a study-specific baseline survey during a contact lens examination or while being evaluated as a candidate for LASIK. Links to follow-up surveys were emailed annually for 3 years. Between-group differences were assessed by analysis of variance, and associations were assessed by logistic multivariate regression. MAIN OUTCOME MEASURES: Visual satisfaction. RESULTS: Of 1800 subjects, 694 (39%) comprised the control group who continued contact lens wear, 819 (45%) wore contacts at baseline and had LASIK, and 287 (16%) wore glasses at baseline and had LASIK. Most contact lens users had worn them successfully ≥5 years. The proportion expressing strong satisfaction with their current vision correction method decreased from 63% at baseline to 54% at year 3 in the contact lens control group, whereas 88% of former contact lens wearers and 77% of former glasses wearers were strongly satisfied with LASIK at year 3. Patients 40 years of age or younger when they had LASIK were somewhat more likely to be strongly satisfied than older patients. LASIK significantly reduced difficulties with night driving and nighttime visual disturbances among former contact lens users and former glasses users. The proportion with dry eye symptoms at 1, 2, or 3 years after LASIK was not significantly increased relative to baseline contact lens wear but was significantly increased relative to baseline glasses use, consistent with many glasses users having tried and abandoned contact lenses because of latent dry eye problems. Compared with continued contact lens wear, LASIK significantly reduced the self-reported rates of eye infections, ulcers, and abrasions each year. CONCLUSIONS: Compared with contact lens wear, current LASIK technology improved ease of night driving, did not significantly increase dry eye symptoms, and resulted in higher levels of satisfaction at 1, 2, and 3 years follow-up.
Subject(s)
Contact Lenses , Hyperopia/therapy , Keratomileusis, Laser In Situ , Myopia/therapy , Patient Satisfaction/statistics & numerical data , Vision Disorders/therapy , Visual Acuity/physiology , Adolescent , Adult , Female , Follow-Up Studies , Health Surveys , Humans , Hyperopia/physiopathology , Male , Middle Aged , Myopia/physiopathology , Prospective Studies , Vision Disorders/physiopathologyABSTRACT
PURPOSE: To study the role of photorefractive keratectomy (PRK) in the management of laser in situ keratomileusis (LASIK) flap complications. METHODS: A retrospective analysis was performed of seven patients (14 eyes) who had bilateral, simultaneous LASIK (single surgeon [TGA], Summit Apex Plus laser, Hansatome microkeratome in six patients [12 eyes], Automated Corneal Shaper keratome in one patient [two eyes]). One eye of each patient received PRK for a flap complication. The seven patients (four women, three men) had a mean age of 39.2 years (range, 22 to 64 yr). The uncomplicated LASIK eyes had moderate to high myopia (-2.25 to -8.75 D) and the eyes with LASIK flap complications had mild to moderate myopia (-1.50 to -5.75 D). Immediate transepithelial PRK was performed in all eyes after repositioning the defective flap. RESULTS: All seven patients had excellent visual outcome at 6 months follow-up; one patient required an enhancement (astigmatic keratotomy). Six of the seven LASIK eyes had best spectacle-corrected visual acuity of 20/20 or better and one LASIK eye had 20/25. In the transepithelial PRK eyes, six of the seven eyes had best spectacle-corrected visual acuity of 20/20 or better and one eye had 20/30. CONCLUSIONS: Immediate transepithelial PRK treatment of irregular and incomplete LASIK flaps at the time of surgery is an excellent therapeutic option to delayed surgical treatment.
