Evaluation of Refractive Accuracy of ORA and the Factors Impacting Residual Astigmatism in Patients Implanted with Trifocal IOLs During Cataract Surgery: A Retrospective Observational Study.

Purpose: To assess the refractive accuracy of the intraoperative aberrometer Optiwave Refractive Analysis (ORA) and evaluate factors impacting residual astigmatism in eyes implanted with PanOptix (TFNT) trifocal intraocular lenses (IOLs) during cataract surgery. Patients and Methods: This retrospective study examined 180 eyes implanted with a toric or non-toric trifocal IOL during cataract surgery. The mean refractive prediction error (RPE), median absolute RPE, and percentage of eyes with an absolute RPE ≤0.25, ≤0.50, ≤0.75, and ≤1.00 diopter (D) were determined for ORA and each of the IOL power formulas (Sanders-|Retzlaff-Kraft/Theoretical [SRK/T], Barrett Universal II, and Haigis). Correlation analysis of postoperative residual astigmatism and factors associated with it was performed using Pearson's and Spearman correlations in eyes with non-toric trifocal IOLs. Results: After optimization, the median absolute RPE was 0.19 D, 0.25 D, 0.20 D, and 0.26 D in eyes measured using ORA and the SRK/T, Barrett Universal II, and Haigis formulas, respectively. An absolute RPE ≤0.50 D after optimization was noted in 92.8%, 83.3%, 88.3%, and 81.1% of the eyes using ORA and the SRK/T (p=0.0093), Barrett Universal II (p=0.2071), and Haigis (p=0.0018) formulas, respectively, showing significant differences between ORA and the SRK/T and Haigis formulas. The mean±standard deviation subjective residual astigmatism in non-toric IOL eyes (N=76) was 0.46±0.39 D and showed a strong positive correlation with preoperative objective refractive astigmatism (r=0.2925, p=0.0109), intraoperative ORA-measured astigmatism (r=0.5555, p<0.0001), postoperative objective refractive astigmatism (r=0.8188, p<0.0001), and postoperative total corneal astigmatism (TCA) (r=0.4051, p=0.0003) and a negative correlation with preoperative anterior corneal astigmatism (r=-0.3541, p=0.0017). Conclusion: ORA is a salient tool for improving the postoperative refractive accuracy of trifocal IOL power calculations and may help in determining the need for toric IOL use in astigmatic eyes with cataracts. Residual astigmatism correlated with objective refractive astigmatism, ORA-measured astigmatism, and postoperative TCA.

Integrated backscatter-intravascular ultrasound and modification of plaque during excimer laser coronary angioplasty.

This study aims to test the hypothesis that the effect of excimer laser coronary angioplasty (ELCA) not only vaporizes thrombi and their underlying coronary plaque, it also changes their quality. We performed a series of cross-sectional analyses in 52 lesions in 51 patients before and after ELCA with integrated backscatter-intravascular ultrasound (IB-IVUS). The constituent parts of the plaque can be assessed by IB-IVUS (i.e., calcified, fibrous, lipid) according to integrated backscatter values. Minimum lumen diameter, lumen volume and vessel volume expanded after ELCA, while plaque volume did not significantly decrease. There was also a decrease of 'lipid' component (35.4-30.3%, P < 0.001) and an increase of IB-IVUS-derived 'fibrous' part (34.5-38.3%, P < 0.001). These results may help in understanding plaque change after ELCA. Excimer laser coronary angioplasty seems to contribute to the modification of coronary plaque composition in addition to debulking it.

Glycerol Monolaurate Inhibits Lipase Production by Clinical Ocular Isolates Without Affecting Bacterial Cell Viability.

PURPOSE: We sought to determine the relative lipase production of a range of ocular bacterial isolates and to assess the efficacy of glycerol monolaurate (GML) in inhibiting this lipase production in high lipase-producing bacteria without affecting bacterial cell growth. METHODS: Staphylococcus aureus,Staphylococcus epidermidis,Propionibacterium acnes, and Corynebacterium spp. were inoculated at a density of 10(6)/mL in varying concentrations of GML up to 25 µg/mL for 24 hours at 37 °C with constant shaking. Bacterial suspensions were centrifuged, bacterial cell density was determined, and production of bacterial lipase was quantified using a commercial lipase assay kit. RESULTS: Staphylococcus spp. produced high levels of lipase activity compared with P. acnes and Corynebacterium spp. GML inhibited lipase production by Staphylococcal spp. in a dose-dependent manner, with S. epidermidis lipase production consistently more sensitive to GML than S. aureus. Glycerol monolaurate showed significant (P < 0.05) lipase inhibition above concentrations of 15 µg/mL in S. aureus and was not cytotoxic up to 25 µg/mL. For S. epidermidis, GML showed significant (P < 0.05) lipase inhibition above 7.5 µg/mL. CONCLUSIONS: Lipase activity varied between species and between strains. Staphylococcal spp. produced higher lipase activity compared with P. acnes and Corynebacterium spp. Glycerol monolaurate inhibited lipase production by S. aureus and S. epidermidis at concentrations that did not adversely affect bacterial cell growth. GML can be used to inhibit ocular bacterial lipase production without proving detrimental to commensal bacteria viability.

Susceptibility of Stenotrophomonas maltophilia clinical isolates to antibiotics and contact lens multipurpose disinfecting solutions.

PURPOSE: To determine the susceptibility of Stenotrophomonas maltophilia to various antibiotics and contact lens multipurpose disinfecting solutions. METHODS: Forty S. maltophilia strains from contact lens cases, contact lenses, or eye swabs of contact lens wearers including 27 asymptomatic wearers and 13 keratitis patients were examined for their susceptibility to different antibiotics, using a disc diffusion assay, and to multipurpose disinfecting solutions using a broth microdilution method. RESULTS: Certain strains were resistant to aztreonum (15%), imipenem (93%), chroramphenicol (13%), and cefepime (8%). Two of those strains were multidrug resistant. All strains were sensitive to trimethoprim-sulfamethoxazole, tigecycline, ceftazidime, and fluoroquinolones. Overall, the minimum inhibitory concentration (MIC) for all strains was significantly higher (P < 0.05) for AQuify (50% dilution) and OPTI-FREE RepleniSH (25%) than all other multipurpose contact lens disinfecting solutions (MPDS) (3%-14%, except RepleniSH versus MeniCare Soft [14%]). AQuify, OPTI-FREE RepleniSH, and MeniCare Soft had significantly higher minimum bactericidal concentrations (undiluted MPDS) than other disinfecting solutions (P < 0.05). CONCLUSIONS: The Australian ocular isolates of S. maltophilia remain susceptible to trimethoprim-sulfamethozole, tigecycline, and most fluoroquinolones. However, the isolates showed resistance to certain multipurpose disinfecting solutions.

Cyclooxygenase (COX)-inhibiting drug reduces HSV-1 reactivation in the mouse eye model.

PURPOSE: To examine the effects of COX inhibitors on suppressing HSV-1 reactivation in a mouse model. METHODS: BALB/c mice were latently infected with HSV-1 and treated by 0.1% bromfenac Na eye drops, 0.1% pranoprofen eye drops, 0.1 mg oral etodolac 4 times/day, and saline for 4 days. After reactivating the latent HSV-1, we swabbed the mouse ocular surface for the culture of the infectious virus and assessed the viral loads in the eyes and trigeminal ganglia (TGs) using real-time PCR to determine the treatment efficacies. RESULTS: With stimulated reactivation, 10 of 24 (41.7%), 5 of 10 (50.0%), 17 of 25 (68%), and 16 of 22 eyes (72.7%) showed positive swab results in the bromfenac Na, etodolac, pranoprofen, and saline groups, respectively; and a significant difference was seen only between the bromfenac Na and saline groups (p = 0.033). None of the three drug-treated groups showed any significant difference from the saline group in the viral DNA in the eyes and TGs (p > 0.05). CONCLUSIONS: Bromfenac Na eye drops can suppress HSV-1 reactivation.