ABSTRACT
The COVID-19 pandemic has forced all nations to take an active role in infection control incorporating recommendations and measures to control viral dissemination. The epidemiological impact is very diverse and dynamic, even within the same region. Scientific knowledge regarding SARS-CoV-2 continues to improve every day with protocols needing to be updated and adjusted on a regular basis. Ophthalmology is a medical specialty identified to be at high risk for several reasons: it has very close doctor-patient contact, the virus has been detected in tears, and the ocular surface serves as a gateway to developing the infection. We have reviewed the current information on SARS-CoV-2 in the ophthalmologic field and provide up-to-date recommendations to help create protocols that can adapt to the dynamic situation of ophthalmologic institutions, patient cases, economic situations and access to diagnostic tests. This paper outlines the main recommendations regarding the initial consultation and outpatient clinics, measures to apply in the operating room (OR), and suggestions for post-surgical controls. Triage, according to the patient's conditions and eye pathology, reduction of the time the patient is at the institution, social distancing, correct use of personal protective equipment (PPE), barrier methods, hygiene, as well as other recommendations mentioned in this document, will allow physicians to take care of the visual health of the patients while reducing the impact of the COVID-19 pandemic.
ABSTRACT
Pterygium is an old challenge for ophthalmic surgeons. Its final resolution is surgical intervention. New surgical techniques have been introduced to improve the outcome, however, the possibility of recurrence always exists. The purpose of this study was to evaluate the pterygium recurrence rate with a long-term follow-up, after surgery was performed with conjunctival autograft and fibrin glue as a biological adhesive. A retrospective case-series study was performed, reviewing cases operated from May 2008 to May 2018 with at least 1 year of follow-up in a private clinic in Buenos Aires, Argentina. The evaluation time-points were at 1 day, 20 days, 6 months, 1 year after surgery and then every year. All the procedures were performed by the same surgeon in single center. Topical Mitomycin C (MMC), 5-Fluorouracil (5-FU), cauterization and/or amniotic membrane were not used in any case. From a total of 159 operated eyes (82/77 women/men), pterygium was recurred in 7 eyes (4.4%); all of them detected at the second follow-up time-point (at day 20). Intraoperative complications did not occur, but at the postoperative stage, one case presented a conjunctival granuloma, which was surgically resolved. In conclusion, a low pterygium recurrence rate was observed after conjunctival autograft with fibrin glue. In our study, recurrence was found at the postoperative first month and did not recur until the end of follow-up for 10 years.
ABSTRACT
BACKGROUND: Acute-onset postoperative endophthalmitis after cataract surgery remains a rare but important cause of visual loss. There is no global consensus regarding the optimal strategies for prophylaxis of endophthalmitis and practices vary substantially around the world, especially with respect to the use of intracameral antibiotics. The European Society of Cataract & Refractive Surgeons in a randomized clinical trial (2007) reported an approximately 5-fold reduction in endophthalmitis rates associated with the use of intracameral cefuroxime. Despite this report, the use of intracameral antibiotics has not been universally adopted. METHODS: Various endophthalmitis prophylaxis patterns around the world (including the United States, Canada, Australia/New Zealand, Japan, China, India, Indonesia, South Africa, Argentina, Russia, Sweden and Mexico) are compared. Each contributing author was asked to provide similar information, including endophthalmitis rates based on published studies, current practice patterns, and in some cases original survey data. Various methods were used to obtain this information, including literature reviews, expert commentary, and some new survey data not previously published. RESULTS: Many different practice patterns were reported from around the world, specifically with respect to the use of intracameral antibiotics. CONCLUSION: There is no worldwide consensus regarding endophthalmitis prophylaxis with cataract surgery.
