Comparison of preoperative and postoperative measurements of optical low-coherence reflectometry biometry and assessment of its refractive predictability.

PURPOSE: To compare the preoperative and postoperative measurements of optical low-coherence reflectometry (OLCR) biometry and assessment of its refractive predictability. METHODS: A total of 114 eyes of 102 patients who underwent cataract treatment were prospectively examined. The axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), K (keratometry) 1, K2, K average (KAVE) and K astigmatic (KAST) values were recorded using Lenstar LS 900 (Haag-Streit, Koeniz, Switzerland) OLCR device. The IOL (intraocular lens) power was measured based on the SRK/T formula. The cases were divided into three subgroups according to AL (Group 1: AL < 22 mm, Group 2: 22 mm ≤ AL < 24 mm, Group 3: 24 mm ≤ AL). The mean absolute error (MAE) calculated for each eye. RESULTS: The right eyes of 45 patients (44.1%), left eyes of 45 patients (44.1%), and both eyes of 12 patients (11.7%) were examined. The average AL in the preoperative period was 23.19 ± 1.01; it was 23.20 ± 0.99 in the postoperative period (p > 0.05). A significant deepening was detected in the postoperative ACD (preop 2.76 ± 0.38 mm, postop 3.81 ± 0.46 mm, p < 0.001). CCT was measured as 521.4 ± 36.3 µm in the preoperative period and as 530.8 ± 42.8 (p > 0.05) µm in the postoperative period. The average mean absolute error (MAE) was measured as 0.48 ± 0.41 D, whereas refractive error was - 0.081 ± 0.67 D. The MAE distribution of cases was found to be ≤ 1.5 D 109 (95.6%) eyes, and ≤ 2.0 D in 114 (100%) eyes. MAE values according to AL of the cases were calculated as 0.71 ± 0.83 D in group 1, 0.49 ± 0.43 D in group 2 and 0.41 ± 0.36 D in group 3 (p > 0.05). CONCLUSION: When the measurement and refractive results of the OLCR biometry were evaluated, it was observed that there was a very satisfactory result and a predictable device compatible with the current literature. The SRK/T formula, one of the new generation formulas, has shown high MAE and RE results in eyes with AL ≤ 22 mm, although not statistically significant. Other new generation formulas should be tried in these eyes.

Comparison of the corneal biomechanical properties, optic nerve head topographic parameters, and retinal nerve fiber layer thickness measurements in diabetic and non-diabetic primary open-angle glaucoma.

The purpose of this study is to investigate the corneal biomechanical properties, optic nerve head (ONH) topographic parameters, and retinal nerve fiber layer (RNFL) thickness changes in primary open-angle glaucoma (POAG) patients with and without diabetes, as well as to evaluate the effect of the metabolic control of diabetes on corneal biomechanical properties, ONH topography, and RNFL thickness. A total of 101 eyes of 101 POAG patients (60 with diabetes and 41 without diabetes) were recruited in this prospective study. Corneal hysteresis and corneal resistance factor (CRF) were both measured using the ocular response analyzer. Optic disk parameters were evaluated using the Heidelberg Retina Tomograph-III. RNFL thickness was measured by using Spectralis HRA + OCT. CRF, mean rim area, and rim volume were found to be significantly higher in the diabetic group when compared with non-diabetic group (p = 0.01 for CRF, p = 0.04 for rim area and p = 0.02 for rim volume). ANCOVA analysis showed statistically insignificant effects of age, gender, MD, and PSD values over rim area and rim volume (p > 0.05). CRF was not significantly correlated with HbA1c levels (p > 0.05). Cup area (CA), cup volume (CV), and cup shape measure (CSM) were weakly correlated with HbA1c levels (r = 0.35 and p = 0.006 for CA; r = 0.32 and p = 0.01 for CV; r = 0.32 and p = 0.01 for CSM). The difference in mean RNFL thickness values between the groups was found to be insignificant (p > 0.05). The results of this study raise doubts whether or not diabetes does in fact shield POAG patients from glaucomatous optic nerve damage from various perspectives.

Corneal biomechanical properties measured by the ocular response analyzer in acromegalic patients.

PURPOSE: To investigate the effect of acromegaly on corneal biomechanical parameters. METHODS: This cross-sectional, comparative clinical study included 34 acromegalic patients and 30 age-matched and sex-matched healthy controls. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated and corneal-compensated intraocular pressure (IOPg and IOPcc, respectively) were measured using the Ocular Response Analyzer. Central corneal thickness (CCT) was determined with the ultrasonic pachymeter. RESULTS: The mean duration of disease for the acromegalic patients was 5.3 years. There was no significant difference between the groups regarding mean CH, CRF, IOPg and IOPcc values. The respective mean values in patients with acromegaly and controls were 10.3 ± 2.2 and 9.5 ± 1.5 mmHg (p = 0.13) for CH; 10.5 ± 2.4 and 9.7 ± 1.7 mmHg (p = 0.16) for CRF, 16.1 ± 3.6 and 15.5 ± 2.9 mmHg (p = 0.49) for IOPg, 16.8 ± 3.4 and 17.0 ± 2.8 mmHg (p = 0.82) for IOPcc, and 544.8 ± 32.2 and 530.7 ± 22.9 µm (p = 0.05) for CCT. A significant moderate correlation was detected between the duration of acromegaly and IOPg OD (r = 0.430, p = 0.01). There was no significant correlation between other ocular parameters and levels of GH and IGF-1 at the time of diagnosis, the status of control, adenoma type, radiotherapy treatment, and drug usage. CONCLUSIONS: In acromegalic patients, the duration of disease was correlated with IOPg OD level. Corneal biomechanical parameters and CCT values were not significantly different than those in age-matched and sex-matched healthy individuals.

Surgical outcomes and incidence of retinal redetachment in cases with complicated retinal detachment after silicone oil removal: univariate and multiple risk factors analysis.

PURPOSE: To analyze the surgical outcomes and retinal redetachment frequency after silicone oil (SO) removal for complex retinal detachment. METHODS: This institutional-based study included 894 consecutive patients who underwent pars plana vitrectomy with SO endotamponade for complicated retinal detachment. The effects of preoperative best-corrected visual acuity, vitreous base shaving, intraoperative scleral buckling, retinectomy, SO viscosity, duration of SO, and vitreous hemorrhage at the first postoperative week on the risk of redetachment were investigated. RESULTS: During a mean follow-up of 39.9 months, anatomical success was not achieved in 118 patients (13.2%) after SO removal. On multivariate analysis, risk factors for recurrent retinal detachment included giant retinal tear (adjusted odds ratio [aOR], 12.39; P < 0.001), high myopia (aOR, 2.70; P = 0.011), surgeries without scleral buckling (aOR, 1.97; P = 0.039), inadequate vitreous base shaving (aOR, 117.62; P < 0.001), and vitreous hemorrhage at the first postoperative week (aOR, 12.13; P < 0.001). CONCLUSION: Retinal detachment etiology, inadequate vitreous base shaving, lack of intraoperative scleral buckling, and vitreous hemorrhage at the first postoperative week after SO removal were significant risk factors for retinal redetachment after SO removal, but preoperative visual acuity, SO viscosity, and duration of SO had no significant effect on redetachment.

Intravitreal silicone oil induced changes in corneal biomechanics.

Our aim was to detect the early effects of pars plana vitrectomy (PPV) combined with intravitreal silicone oil (SO) on corneal biomechanics. 19 eyes underwent PPV with SO tamponade (group 1) and 16 eyes underwent. PPV without tamponade (group 2). Corneal biomechanical parameters were measured preoperatively and at the first postoperative month by ocular response analyzer. The mean preoperative intraocular pressure (IOP) by Goldmann applanation tonometry (GAT) and the mean corneal-compensated intraocular pressure (IOPcc) were significantly lower in group 1 than group 2 (p = 0.005, p = 0.002, respectively). The mean preoperative corneal hysteresis (CH) and corneal resistance factor (CRF) were significantly higher in group 1 than group 2 (p = 0.017, p = 0.002, respectively). However, the difference in Goldmann-correlated intraocular pressure (IOPg) between the groups was not significant (p = 0.360). In group 1, IOPcc, IOPg and IOP-GAT significantly increased postoperatively (p = 0.002, p = 0.004, p = 0.002, respectively) but CH and CRF decreased (p = 0.007, p = 0.153, respectively). In group 2, IOPcc, IOPg and IOP (GAT) increased postoperatively but the differences were not significant (p = 0.851, p = 0.693, p = 0.336, respectively). The mean CRF increased significantly (p = 0.026) postoperatively but the decrease in CH was not significant (p = 0.196). Statistically significant differences were found in the changes of preoperative and postoperative means of IOPcc, IOPg, IOP-GAT and CRF between the groups (p = 0.024, p = 0.037, p = 0.014, p = 0.006, respectively). However, the difference in the decreases in CH between the two groups was not statistically significant (p = 0.206). SO tamponade may affect corneal biomechanical parameters in the early postoperative period, which may be related to the surgery itself, SO tamponade or IOP changes.

Corneal biomechanical characteristics in children with diabetes mellitus.

To compare the corneal biomechanical properties in children with type 1 diabetes mellitus (DM) and healthy children. In this cross-sectional study, the study and control groups were composed of 68 children with DM and 74 healthy children, respectively. The corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) were measured with the ocular response analyzer (ORA). Associations between ocular and diabetic parameters were also evaluated. There were no statistically significant differences between the two groups in age or gender distribution. The mean CH was 10.8 ± 1.5 and 10.7 ± 1.7 mmHg while the mean CRF was 10.9 ± 1.9 and 10.5 ± 1.6 mmHg in the diabetic group and control group, respectively. The mean IOPg was 15.9 ± 3.7 and 15.2 ± 3.4 mmHg, and the mean IOPcc was 15.8 ± 3.0 and 15.3 ± 3.4 mmHg in the diabetic and control group, respectively. There were no statistically significant differences between the two groups for CH, CRF, IOPg, and IOPcc measurements (independent t test, p = 0.624, p = 0.207, p = 0.263, p = 0.395, respectively). This study shows that type 1 DM does not have any effect on the corneal biomechanical parameters in childhood.

Early effects of pars plana vitrectomy combined with intravitreal gas tamponade on corneal biomechanics.

PURPOSE: To detect the early effects of pars plana vitrectomy (PPV) combined with intravitreal gas tamponade on corneal biomechanics and compare these effects of sulfur hexafluoride (SF6) and perfluropropane (C3F8). METHODS: 19 eyes underwent PPV with C3F8, 14 eyes underwent PPV with SF6 tamponade and 16 eyes underwent PPV without tamponade. Corneal biomechanical parameters were measured preoperatively and at the first postoperative week by an ocular response analyzer. RESULTS: There were no significant differences of corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg) between the groups preoperatively. The mean CRF, IOPcc and IOPg significantly increased at the first postoperative week in the C3F8 group. In the SF6 group, CRF increased significantly but the increases in IOPcc and IOPg were not significant. In the PPV group, the increases in CRF, IOPcc and IOPg were not significant. The mean CH decreased in the C3F8, SF6 and PPV groups postoperatively but these results were not significant. No statistically significant differences were found between the changes of preoperative and postoperative CH, CRF and IOPg between the groups, but the increase in IOPcc was statistically significantly higher in the C3F8 group than the others. CONCLUSION: SF6 and C3F8 gas tamponade may affect corneal biomechanical parameters at the early postoperative period which should be related with surgery, gas tamponade or intraocular pressure changes.

Thirteen-year vitreoretinal surgical outcomes of 5,097 cases from a tertiary referral center in Turkey.

A 13-year retrospective chart review of 5,097 consecutive cases that underwent pars plana vitrectomy (PPV) in a tertiary referral center in Turkey was performed. Age at onset, sex, laterality, associated systemic disease, pre- and postoperative visual acuities (VA), indications, type of surgery and outcomes of surgery were analyzed. The most common indications for vitreoretinal surgery (VRS) were rhegmatogenous retinal detachment (n = 1,802, 35.4%) and proliferative diabetic retinopathy (n = 1,505, 29.5%). The most common vitreoretinal technique combinations performed were PPV with encircling endolaser (EL) and phacoemulsification with intraocular lens implantation (33.0%), PPV with encircling EL (30.4%), and only PPV (7.0%). A statistically significant increase in the mean VA was noted at the first- (1.16 ± 0.44 logarithm of the minimum angle of resolution, logMAR) and sixth-month (1.06 ± 0.61 logMAR) visits when compared to the preoperative VA (1.77 ± 0.58 logMAR; p < 0.001). Comparisons in the top surgical indications, techniques and outcomes for vitrectomy between the countries could be important for the development of subspecialization in VRS.

Microtrauma-induced recurrent hyphema and secondary glaucoma associated with chronic acetylsalicylic acid use.

To report a case of microtrauma-induced recurrent hyphema and secondary glaucoma associated with voluntary chronic acetylsalicylic acid (ASA) use. A 43-year-old male developed advanced glaucoma in his right eye after a two-month followup period of recurrent microhyphema, which had been induced by strong eye-rubbing. In spite of topical and systemic antiglaucoma medication, as well as topical corticosteroid and cycloplegic drugs and bed rest under hospitalization, the hyphema and glaucoma were not controlled. His medical history revealed that he had been using ASA for 2 years in order to prevent heart attacks. We asked the patient to stop ASA intake and the hyphema cleared considerably on the third day after discontinuation of the drug. One week after stopping ASA, trabeculectomy with mitomycin C was performed without any complications. Glaucoma and recurrent hyphema were controlled after surgery without any medical treatment. Chronic ASA intake may cause recurrent hyphema and secondary glaucoma even after a microtrauma. Medical histories of patients must always be taken, especially in cases of prolonged recurrent hyphema.

A 1.5 cm-long unknown subconjunctival grass inflorescence misdiagnosed as relapsing conjunctivitis for one year.

Foreign bodies are usually detected at the first visit. However, they may be overlooked sometimes, especially in children, and may cause some clinical conditions including unilateral relapsing conjunctivitis. A five-year-old girl was presented to the emergency clinic of our hospital with epiphora, purulent discharge, eyelid swelling, and a foreign body feeling in her right eye. The symptoms had been present for one year, and the patient was treated for relapsing conjunctivitis. In slit lamp examination performed with difficulty because of the patient's lack of cooperation, a localized edema and erythema were observed under the right eyelid. An exploration under general anesthesia was planned, and a 1.5 cm-long subconjunctival grass inflorescence was removed. An unknown subconjunctival foreign body should be considered in each patient with relapsing conjunctivitis, especially in children, even in the absence of ocular trauma.

Autofluorescence and optical coherence tomography findings in optic disc pit-associated maculopathy: case series.

The aim of this case series was to report and discuss the clinical, fundus autofluorescence (FAF), and optical coherence tomography (OCT) findings of four eyes of three cases with optic disc pit (ODP)-related serous macular detachment. Three cases were referred to the retina department of our hospital for decreased visual acuities in four of their eyes. In addition to ophthalmological examinations, OCT and FAF were also performed. ODP-related serous macular detachment was detected clinically in all the eyes. OCT also showed two typical components named as 'bilaminar structure' in all eyes and OCT and FAF photography showed precipitates in the retinal outer layers of the detachment area in three eyes. OCT and autofluorescence photography findings can support clinical observations in the diagnosis of ODP-related maculopathy.

Relationships between corneal biomechanics and the structural and functional parameters of glaucoma damage.

PURPOSE: To investigate the relationships between (i) thickness of the retinal nerve fiber layer, optic nerve head topography, and visual field parameters and (ii) corneal biomechanical properties in normal controls and patients with ocular hypertension and primary open-angle glaucoma. METHODS: This observational, cross-sectional study included 68 eyes with primary open-angle glaucoma, 99 eyes with ocular hypertension and 133 control eyes. Corneal biomechanical properties, optic nerve head topographic features, retinal nerve fiber layer thickness, and visual fields were assessed in all cases. Corneal biomechanical properties, retinal nerve fiber layer thicknesses, and optic nerve head topographic features were compared among the groups. The associations between structural and functional measures of glaucomatous damage and corneal biomechanical factors were also evaluated. RESULTS: Significantly lower corneal hysteresis and corneal resistance factor values were observed in the primary open-angle glaucoma and ocular hypertension groups as compared with the control group, but there were no significant differences between the primary open-angle glaucoma and ocular hypertension groups. In the ocular hypertension group, no associations were observed between the corneal hysteresis and corneal resistance factor with values and the structural and functional parameters. In the primary open-angle glaucoma group, positive correlations were observed between the corneal hysteresis values and the global retinal nerve fiber layer thickness (p<0.01, r=0.27), mean retinal nerve fiber layer thickness (p<0.01, r=0.33), and mean deviation (p<0.01, r=0.26), and negative correlations were observed between the corneal resistance factor values, and the cup area (p<0.01, r=-0.39), cup-to-disk ratio (p=0.02, r=-0.28), linear cup-to-disk ratio (p=0.02, r=-0.28), and cup shape (p=0.03, r=-0.26). In the control group, weak correlations were detected between the corneal hysteresis and the cup area (p=0.03, r=0.19), cup-to-disk ratio (p=0.01, r=0.21), and linear cup-to-disk ratio (p=0.01, r=0.22). CONCLUSIONS: Distinct correlations were identified between the corneal hysteresis and corneal resistance factor values and the functional and structural parameters in the primary open-angle glaucoma and control groups. Corneal hysteresis and corneal resistance factor may have different roles in the pathophysiology of glaucoma.

A comparison among Humphrey field analyzer, Microperimetry, and Heidelberg Retina Tomograph in the evaluation of macula in primary open angle glaucoma.

PURPOSE: It is known that macula can be affected adversely in glaucoma. In this study, we aimed to evaluate the functional and morphologic changes of macula in patients having glaucoma using Microperimeter-1 (MP-1), Humphrey field analyzer (HFA), and Heidelberg Retina Tomograph II (HRT-II). MATERIALS AND METHODS: This prospective study consisted of 43 patients having primary open angle glaucoma. Control group consisted of 26 normal cases. Macular threshold was evaluated with HFA macula threshold test and MP-1 Humphrey macula pattern. Morphometric evaluation of macula was performed with HRT-II. The results were evaluated by independent samples t test and receiver operator curves. RESULTS: Macular sensitivity was lower in patients having glaucoma with both HFA and MP-1 in all quadrants (P=0.003 for HFA and P=0.002 for MP-1). The macular thickness measurements obtained with HRT-II was not significant between glaucoma patients and control group (P=0.153). The difference between HFA and MP-1, HFA and HRT-II, MP-1 and HRT-II was not statistically significant (P=0.302, 0.110, and 0.481, respectively). CONCLUSIONS: Perimetric macular changes can occur while macular topographic remains stable in patients with glaucoma. MP-1 correlates with HFA in detecting glaucomatous visual field defect in macular area.

Meibomian gland alterations in polycystic ovary syndrome.

PURPOSE: Polycystic ovary syndrome (PCOS) is an endocrinopathy characterized by chronic anovulation and hyperandrogenism where hyperinsulinemia can be seen. Hormonal changes can affect meibomian gland function. In this study, we evaluated tear function in PCOS. MATERIALS AND METHODS: Twenty-seven women having PCOS and 22 normal individuals aged between 18-42 years were enrolled in the study. Patients were asked about dry eye symptoms. Schirmer test, tear film breakup time, and rose Bengal staining were performed. Conjunctival brush cytology specimens were obtained and goblet cell count was done. RESULTS: Dry eye symptoms were more frequent in subjects with PCOS (p=0.025). Mean breakup time was shorter in women with PCOS (p=0.034). Schirmer test results, rose Bengal staining scores, and goblet cell count were not different between groups (p=0.48, p=0.18, p=0.82, respectively). CONCLUSION: Meibomian gland function and tear film lipid layer can be affected in cases with PCOS.

Is pseudoexfoliation associated with sensorineural hearing loss?

OBJECTIVE: To determine the possible relation between pseudoexfoliation (PSX) and sensorineural hearing loss. METHODS: This study was carried out in Afyon Kocatepe University, Afyon, Turkey between July 2002 and June 2005. Sixty-three patients who were found to have ocular PSX on routine biomicroscopic examination, and 38 age-matched control subjects were evaluated for evidence of audiometric abnormality. The sum of pure-tone hearing threshold measured at 250-2000 Hz, 2000-6000 Hz, and 250-6000 Hz in each ear was compared with controls for the same frequencies. RESULTS: The mean age of the patients was 68.4+/-10.3 years. All patients had PSX affecting at least one eye. Fifty (79.4%) patients with PSX, and 10 (26.3%) control subjects were found to have hearing loss (p=0.00, chi-square). From the 50 patients with PSX who had hearing loss, 34 patients had bilateral PSX, and 16 patients had unilateral PSX. Twenty-nine patients had high frequency hearing loss, while 20 patients had hearing loss in all frequencies. Forty-eight patients with PSX and 7 controls had bilateral sensorineural hearing loss (p=0.030). CONCLUSION: Sensorineural hearing loss was seen more frequently in patients with PSX in comparison with age-matched control subjects.

Increased levels of circulating CD34+ cells in neovascular age-related macular degeneration: relation with clinical and OCT features.

PURPOSE: To investigate the levels of circulating CD34+ stem cells in patients with neovascular type age-related macular degeneration (AMD) and its relation with clinical and optical coherence tomography (OCT) findings. METHODS: The study consisted of 55 patients: 28 patients (18 male and 10 female) with neovascular type AMD as a study group and 27 patients (12 male and 15 female) scheduled for cataract surgery as a control group. The level of CD34+ stem cells was measured by flow cytometry. Demographic and clinical data were recorded. RESULTS: The mean ages of patients in the study and control groups were 71 ± 8 and 68 ± 6 years, respectively. There was no statistically significant difference in terms of age, sex, or systemic disease association between study and control groups. However, smoking status was significantly higher in the study group (67.9% vs 37.0%; p = 0.02). Stem cell levels were significantly higher in the study group (1.5 ± 0.9 vs 0.5 ± 0.3; p<0.001), but there was no relation between stem cell levels and clinical and OCT findings. CONCLUSIONS: Increased circulating CD34+ stem cell levels were observed in patients with choroidal neovascular membrane associated with AMD, but no significant relation was found between cell levels and clinical and OCT findings.

Preoperative topical indomethacin to prevent pseudophakic cystoid macular edema.

PURPOSE: To evaluate the effectiveness of a nonsteroidal antiinflammatory drug (NSAID) on pseudophakic cystoid macular edema (CME) and determine the efficacy when used preoperatively and after uneventful phacoemulsification surgery. SETTING: Department of Ophthalmology, Kocatepe University, School of Medicine, Afyonkarahisar, Turkey. METHODS: One hundred seventy-nine eyes of 189 patients having uneventful phacoemulsification surgery were enrolled in the study. After surgery, all patients used topical steroids and antibiotics 4 times daily. Sixty-one eyes, chosen randomly, received a topical NSAID (indomethacin) 4 times daily for 3 days preoperatively and 1 month postoperatively. Sixty eyes received topical indomethacin 4 times daily for 1 month postoperatively. Fifty-eight eyes served as a control group and received only topical steroids and antibiotics. At the third postoperative month, visual acuity, fluorescein angiograms, and macular thresholds were evaluated. Statistical analysis was by chi-square and 1-way analysis of variance tests. RESULTS: Cystoid macular edema was not seen in the group receiving indomethacin preoperatively and postoperatively. The incidence of angiographic CME was 15.0% in the group receiving postoperative indomethacin and 32.8% in the control group (P<.001). Mean sensitivity in the macular threshold test did not show a significant change between groups (P = .83). Postoperative visual acuity was significantly higher in the group receiving preoperative indomethacin (P<.001). CONCLUSION: Nonsteroidal antiinflammatory drugs decreased the incidence of CME, and their efficacy increased when begun preoperatively.

Hyperopic shift with posterior bowing of a Collamer posterior chamber intraocular lens.

Two patients developed a hyperopic shift following uneventful phacoemulsification with implantation of a Collamer plate-haptic intraocular lens (Staar Surgical) in the capsular bag. Posterior bowing of the IOL was corrected by IOL exchange, achieving near emmetropia.

Efficacy of topical caspofungin in experimental fusarium keratitis.

PURPOSE: To evaluate the efficacy of caspofungin in an experimental rabbit model of Fusarium keratitis and to compare it with amphotericin B. METHODS: Eighteen New Zealand white rabbits were randomly divided into 2 treatment groups and 1 control group. One cornea of each rabbit was inoculated with Fusarium solani spores. The first group received topical amphotericin B 0.15%, the second group received topical caspofungin 1%, and the control group received topical balanced salt solution hourly for 2 days and then 4 times daily for 3 additional days. Treatment effects were evaluated by clinical assessment at days 3 and 5 and by fungal culture after 5 days of treatment. RESULTS: In the treatment groups, progression of keratitis was inhibited, and cultures were sterile at the end of the study. In the control group, keratitis progressed, and cultures were positive for F. solani. CONCLUSIONS: Topical caspofungin is effective in Fusarium keratitis, and clinical efficacy studies seem justified.

Effects of intravitreal moxifloxacin and dexamethasone in experimental Staphylococcus aureus endophthalmitis.

PURPOSE: To evaluate the effects of intravitreal moxifloxacin and moxifloxacin and dexamethasone combination in an experimental rabbit model of Staphylococcus aureus endophthalmitis. METHODS: The right eyes of 24 rabbits weighing 2 to 3 kg were used. Ten thousand colony-forming units (CFU) of S. aureus in 0.1 ml saline solution were inoculated into the vitreous cavity. The eyes were randomly assigned to one of the four groups equally. Twenty-four hours after the inoculation of S. aureus, group 1 received 50 microg moxifloxacin, group 2 received 50 microg moxifloxacin plus 400 microg dexamethasone, and group 3 received 1 mg vancomycin intravitreally. No treatment was given to group 4. Clinical examination scores were recorded. Vitreous aspirates were obtained for microbiological analysis just before sacrifice, and the eyes were enucleated for histopathologic examination. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests. RESULTS: In all treatment groups, mean number of CFU and histopathologic score were significantly lower compared with control group (p<0.05), and the difference between treatment groups was not statistically significant (p>0.05). The clinical score was not significantly different between groups (p>0.05). CONCLUSIONS: Intravitreal injection of 50 microg moxifloxacin was effective in the treatment of S. aureus endophthalmitis. Bacteriological, histopathologic, and clinical outcomes after treatment using moxifloxacin, moxifloxacin and dexamethasone combination, and vancomycin were comparable. Intravitreal moxifloxacin may be an option in the treatment of S. aureus endophthalmitis.