Is ethnicity a risk factor for severe retinopathy of prematurity?

OBJECTIVE: To assess the risk of severe retinopathy of prematurity (ROP) requiring treatment in different ethnic groups. DESIGN: Retrospective observational study on ROP screening and treatment. It involved a cross-sectional review of all eligible infants over a seven-year period. Statistical tests used were the Kruskal-Wallis test and Mann-Whitney U test. Logistic regression was used to control for any differences in birth weight and gestational age. SETTING: City Hospital and Birmingham Women's Hospital, Birmingham, UK. RESULTS: 1690 preterm infants underwent ROP screening. Birth weight was lower in black (1142.5 g) and Asian infants (1180 g) when compared to white infants (1196.5 g). Gestational age was lower in black infants (28.5 weeks) compared to Asian and white infants (both 29 weeks). Compared to white infants, the odds of severe ROP requiring treatment was higher in Asian infants (odds ratio (OR): 2.52; 95% CI 1.41 to 4.50) and black infants (OR: 2.51; 95% CI 1.30 to 4.86). The additional risk from ethnicity was present even after adjusting for birth weight and gestational age (adjusted OR for Asian vs white infants: 2.45; 95% CI 1.334 to 4.497); (adjusted OR for black vs white infants: 2.0; 95% CI 1.004 to 4.014). CONCLUSIONS: Ethnicity is a risk factor for severe ROP. Asian and black infants have a higher risk of developing threshold ROP compared to white infants.

The use of voriconazole in the treatment of cylindrocarpon keratomycosis.

PURPOSE: To describe a rare form of fungal keratitis due to Cylindrocarpon lichenicola. METHOD: A 56-year-old woman presented with an atypical corneal ulcer that did not respond to broad- spectrum antibiotics. RESULTS: Additional diagnostic tests such as confocal microscopy and corneal biopsy were useful aids in establishing the diagnosis of fungal keratitis. The ulcer healed completely after the initiation of antifungal therapy. CONCLUSIONS: To the best of our knowledge, this is the first case of C. lichenicola keratomycosis in the United Kingdom. Our case demonstrates that prompt recognition and effective treatment of this condition can lead to a good visual outcome.

Outcomes of sulcus implantation of Array multifocal intraocular lenses in second-eye cataract surgery complicated by vitreous loss.

PURPOSE: To evaluate the outcomes of implantation of the Array((R)) multifocal intraocular lens (IOL) (model SA-40N, AMO) in the ciliary sulcus in second-eye cataract surgery complicated by vitreous loss. SETTING: Department of Ophthalmology, Arrowe Park Hospital, Wirral, United Kingdom. METHODS: This retrospective study comprised 15 patients who had complicated second-eye cataract surgery with loss of posterior capsule support leading to sulcus implantation of an Array multifocal IOL. The patients were recalled for assessment. Objective evaluation included uncorrected and corrected distance and near visual acuities, complications, and IOL centration. Subjective assessment was performed using a questionnaire that included the VF-14 index of visual function; the questions were related to satisfaction with vision, limitations from halos and glare, and the frequency of spectacle wear. RESULTS: Fourteen eyes (93%) had postoperative visual improvement. The best corrected distance acuity was 6/12 or better in 11 eyes (73%). The best corrected near acuity was J2 or better in 12 eyes (80%). The IOL was well centered in 11 eyes (73%) and slightly decentered in 4 eyes (27%). Subjectively, patients indicated a high level of satisfaction with their distance and near vision. The VF-14 indicated high levels of visual function, with 73% of patients having a score higher than 90 (out of 100). Seventy-three percent of patients were not troubled by glare or halos, and 40% did not wear spectacles. CONCLUSION: Implantation of the Array multifocal IOL in the sulcus during complicated phacoemulsification led to good visual outcomes based on objective and subjective patient measures.

Entry of antibiotic ointment into the anterior chamber after uneventful phacoemulsification.

A 77-year-old woman had uneventful phacoemulsification. Postoperative examination revealed that chloramphenicol ointment instilled in the conjunctival fornix had entered the anterior chamber and smeared the intraocular lens (IOL). Immediate surgical removal of the ointment with IOL exchange was performed. The eye settled in 6 weeks with a best corrected visual acuity of 6/9. This case raises concerns about the integrity of clear corneal incisions and the need for postoperative review of uneventful phacoemulsification surgery.