Postoperative sterile endophthalmitis (TASS) associated with the memorylens.

PURPOSE: To report 10 cases of delayed-onset acute intraocular inflammation following cataract extraction and posterior chamber implantation of the MemoryLens(R) intraocular lens (IOL). SETTING: John A. Moran Eye Center, Department of Ophthalmology, University of Utah, Salt Lake City, Utah, USA. METHODS: This retrospective study evaluated 10 cases of postoperative inflammation that occurred after cataract extraction with placement of the posterior chamber MemoryLens IOL. Protocols of the Intermountain Ocular Research Center used to analyze outbreaks of unexplained postoperative inflammation as well as medical records were reviewed. RESULTS: Nine patients had uneventful cataract extraction and 1 had a small anterior capsule tear with placement of the MemoryLens IOL. All 10 patients presented with increased anterior segment inflammation a mean of 7.8 days (range 1 to 21 days) after surgery. Three cases were tapped and were culture negative, and 7 were presumed noninfectious. The anterior segment inflammation improved in all patients. Treatment of the 7 patients included intensive topical steroids. Careful analysis of the inflammation has not revealed an obvious etiology; however, the MemoryLens was associated with all the cases. CONCLUSIONS: We postulate that these cases of noninfectious postoperative endophthalmitis may be associated with the MemoryLens.

Efficacy of diclofenac sodium solution in reducing discomfort after cataract surgery.

Two hundred consecutive patients were enrolled in a randomized, prospective clinical trial evaluating the efficacy of diclofenac sodium (Voltaren Ophthalmic) in reducing patient discomfort after cataract surgery. Other factors evaluated were the effect of preoperative flurbiprofen (Ocufen) in preventing intraoperative miosis and on postoperative discomfort and the effect of incision size and intraocular carbachol (Miostat) on postoperative comfort. Diclofenac significantly reduced discomfort during the first 24 hours after surgery but not two to three days postoperatively, although there was a trend toward reduction. Flurbiprofen given preoperatively did not affect postoperative discomfort. It also did not affect pupil size at the start of surgery but did reduce intraoperative miosis. Incision size (5.2 mm versus 7.0 mm) had no effect on discomfort. Miostat did not affect discomfort, although there was a trend toward more discomfort. The results indicate that topical diclofenac, given immediately after cataract surgery, significantly reduces discomfort during the first 24 postoperative hours.

Healon GV in extracapsular cataract extraction with intraocular lens implantation.

A randomized masked study was performed to compare Healon GV, a new higher molecular weight sodium hyaluronate viscoelastic, with Healon in extracapsular cataract surgery with posterior chamber intraocular lens insertion. Seventy patients were randomly divided into two groups. Postoperative intraocular pressures, pachymetry, endothelial cell counts and morphology, amount of viscoelastic and irrigating solution used, difficulty of surgery, and postoperative flare and cells were measured. Postoperative pressures were not significantly different between the Healon and Healon GV treatment groups, except at the eight-hour observation period, when the pressure was higher in the Healon GV group (P = .02). There was a significant (P = .002) reduction in the amount of viscoelastic required in the Healon GV group. Cell counts and morphology were not significantly different between the groups. Other parameters showed no significant difference. Clinically, Healon GV handled like Healon during instillation into the anterior chamber and aspiration at the end of the case. It did, however, appear to be much more effective at maintaining the anterior chamber, as demonstrated in the smaller amount of viscoelastic required.

Effect of drying period and soil moisture on egg hatch of the tadpole shrimp (Notostraca: Triopsidae).

Tadpole shrimp (Triops spp.) are potential biological control agents against larval mosquitoes in temporary ponds and flood-irrigated fields. In some rice field situations, however, they may become pests that uproot and eat young rice plants. In cursory observations, it has been reported that tadpole shrimp eggs do not readily hatch on flooding when the soil or substrate containing eggs is moist before flooding. The relationship between drying (moisture content) of soil and tadpole shrimp hatch was determined in studies conducted in mesocosms at the University of California Aquatic and Vector Control Research facilities at Riverside and at Oasis in the Coachella Valley of southern California. In laboratory hatching trials, an increase in hatch of Triops longicaudatus (LeConte) with declining soil moisture content was demonstrated (t = 8.4, P less than 0.001; r2 = 0.76). In field trials in mesocosms at Riverside, egg hatch increased with increased drying period and declining soil moisture content (G = 29.8, P less than 0.01). No hatch of eggs occurred after 3 d of drying, when soil moisture content was high, but a high level of hatching occurred after 7 and 14 d of drying, when soil moisture declined to low levels. At Oasis, soil moisture did not decrease with drying time because of porous soil and capillary action of water from adjacent flooded mesocosms and thick vegetation covering the pond bottoms. Therefore, hatch rates at Oasis were not associated with the length of the drying period (G = 35, P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of the postoperative intraocular pressure with Betagan, Betoptic, Timoptic, Iopidine, Diamox, Pilopine Gel, and Miostat.

A randomized, masked study measuring postoperative intraocular pressure at 4, 8, and 24 hours, two to seven days, and one month after planned extracapsular cataract extraction with posterior chamber lens implantation was conducted. Seven commonly used ocular hypotensive agents and a control, given at the completion of surgery, were compared: timolol maleate (Timoptic), levobunolol hydrochloride (Betagan), betaxolol hydrochloride (Betoptic), pilocarpine hydrochloride (Pilopine Gel), carbachol (Miostat), apraclonidine hydrochloride (Iopidine), acetazolamide (Diamox). There were significant differences between agents. Miostat was the most effective in controlling postoperative IOP, followed by Timoptic. Diamox, Pilopine Gel, and Betagan were equally effective. Betoptic was somewhat less effective and Iopidine was not significantly better than the control.

Postoperative intraocular pressure rises: a comparison of Healon, Amvisc, and Viscoat.

A prospective randomized study was performed involving 200 patients divided into four groups: (1) Healon aspirated, (2) Amvisc aspirated, (3) Viscoat aspirated, and (4) Viscoat not aspirated. Postoperative intraocular pressures were measured at 4, 8, and 24 hours, two to three days, and one month. Significant differences between the groups were noted at four and eight hours; however, by 24 hours there were no significant differences. There were also no significant differences at two to three days and one month postoperatively. In this study, the Viscoat-not-aspirated group had the highest intraocular pressures followed, in decreasing order, by the Viscoat aspirated group, the Amvisc aspirated group, and the Healon aspirated group. From this study, I have concluded that Viscoat should be aspirated at the end of surgery to avoid postoperative intraocular pressure rises. Healon appears to be associated with lower intraocular pressures than the other two agents at four and eight hours postoperatively.