Antimicrobial biomaterials and their potential application in ophthalmology.

Infections associated with the use of intraocular, periocular, or orbital implants are associated with an increase in both morbidity and in the costs of ophthalmological surgery. This is due to an increased number of visits and the need for additional treatments, at a time when some conventional therapies are losing their efficacy, or even hospitalization. To avoid such consequences, the first step should be to prevent the biomaterials that form implants from being colonized by various microorganisms, either intraoperatively or postoperatively. To this end, several lines of research have emerged that aim at equipping implants with antimicrobial properties, some of which are described in this review.

Pericranium grafts for exposed orbital implants: An observational case-series study.

OBJECTIVE: The aim of this article is to highlight our experience with autologous pericranium graft in wide exposures (≥3 mm). The pericranium graft was taken from the parietal region of the scalp in six consecutive clinical cases of orbital implant exposure in anophthalmic sockets. MATERIAL AND METHODS: This is a prospective, descriptive case series study of patients who had orbital implant exposures and were treated with autologous pericranium graft. RESULTS: The average postoperative follow-up period was 10 months, and the mean time for conjunctivalization of the graft was 3 months. In all cases, complete conjunctivalization was achieved, and no re-exposure of the implant was observed. CONCLUSIONS: The pericranium graft from the parietal region is an effective technique to treat both small and large orbital implant exposures with no comorbidity. Time to complete conjunctivalization is similar to that of other autologous grafts. It is a simple and convenient method for the oculoplastic surgeon that constitutes a good alternative for covering anophthalmic cavities. Further studies with more cases and longer follow-up are required to confirm the effectiveness of this technique.

Long-term safety and visual outcomes of anterior chamber intraocular lens implantation in patients with a history of chronic uveitis.

PURPOSE: To compare the visual outcomes and prevalence of long-term complications in patients with quiescent uveitis after phacoemulsification with traditional in-the-bag intraocular lens (IOL) implantation versus primary or secondary anterior chamber (AC) IOL implantation due to inadequate capsule support. SETTING: Single-center private practice. DESIGN: Retrospective observational cohort study. METHODS: Patients with quiescent uveitis who had cataract surgery with subsequent AC IOL implantation were identified through an electronic medical record database. They were age matched with patients with uveitis who had conventional placement of a posterior chamber (PC) IOL. The rate of postoperative complications and corrected distance visual acuity (CDVA) were reviewed preoperatively and 1, 3, and 6 months and 1, 2, 3, and 4 years postoperatively. RESULTS: The incidence of postoperative complications was not statistically different for any criterion except posterior capsule opacification development in the PC IOL cohort (relative risk, 0.071). The mean follow-up was 36.11 months ± 17.3 (SD) in the AC IOL group and 53.72 ± 20.4 months in the PC IOL group. The mean preoperative CDVA was 1.49 ± 1.07 logMAR in the AC IOL group and 0.5 ± 0.26 logMAR in the PC IOL group. Both groups had a significant improvement in CDVA visual acuity 3 years postoperatively (P=.001 and P=.010 respectively). CONCLUSIONS: In uveitic eyes with inadequate capsule support, AC IOL implantation was safe and effective in providing satisfactory improved CDVA without a significant increase in long-term complications compared with eyes that had PC IOL placement.