[PHOTOKERATITIS AS RESULT OF DOMESTIC EXPOSURE TO ULTRAVIOLET-C (UVC) LIGHT].

INTRODUCTION: During the global outbreak of coronavirus disease 2019 pandemic, people sought ways to disinfect their domestic and public surroundings. One of the sanitation options included the usage of ultraviolet-C (UVC) lamps since UVC radiation has been shown to effectively inactivate the SARS-Coronavirus. UVC radiation may also be effective against the SARS-CoV-2 virus. Here we report four cases of bilateral photokeratitis due to the improper usage of UV lamps during the first outbreak of COVID-19 in Israel. METHODS: We collected 4 case reports from patients who were diagnosed with bilateral photokeratitis due to improper usage of UV lamps in their domestic environment from May to December 2020 during the first outbreak of COVID-19 in Israel. RESULTS: A total of four patients presented with signs and symptoms of bilateral photokeratitis after exposure to UV lamps. DISCUSSION: Acute exposure of UVC to the cornea may cause "burns", known as photokeratitis. The signs of photokeratitis usually appear a few hours after the exposure. Precautious steps to educate the population must include using protective eyewear in any exposure to UV light and avoiding the use of germicidal lamps in public locations with exposure to the population.

[Diabetic retinopathy following cataract surgery].

BACKGROUND: Approximately 20% of patients undergoing cataract surgery have diabetes mellitus. AIM: To evaluate the course of diabetic retinopathy after cataract surgery. METHODS: Diabetic patients with no or mild to moderate preoperative diabetic retinopathy were included and classified into 4 groups (A-D): A--The course of retinopathy, B--macular edema, C--the effect of voltaren ophtha eye drops and D--systemic glycemic control. Group E included eyes with previous laser treatment for proliferative retinopathy. Clinical and angiographic retinal findings were scored before and after surgery. Progression was defined as an increase in the retinal score. In groups A, C, D and E the non-operated eye served as a control. In group B, the eyes of nondiabetic patients who had undergone cataract surgery served as a control. RESULTS: Retinopathy was stable in 66% and progressed in 34% (p < 0.005). Progression occurred during the first 6 postoperative months in 84%. Preoperative retinopathy was a risk factor for progression. Good visual acuity was achieved in 67% and was correlated with: preoperative retinopathy and postoperative deterioration. Macular edema was found in 50% of eyes compared to 8% of the controls (p < 0.005). Its development was correlated with preoperative retinal status. Twenty six eyes were treated with voltaren eye drops and 24 with placebo. Progression of macular edema was seen less often in eyes treated with voltaren (p < 0.001). Deterioration of retinopathy was less common in cases when HbA1C was equal to or lower than 7.5 mg%. CONCLUSIONS: Close retinal follow-up after cataract surgery is recommended, especially in patients with preoperative diabetic retinopathy. Systemic control of diabetes and antiinflammatory eye drops may improve surgical results.

Results of combined surgery by phacoemulsification and vitrectomy.

BACKGROUND: Eyes scheduled for posterior segment surgery may have cataract, which obscures the visualization of the retina. Surgery may be carried out either by a two-step procedure: i.e., removal of the cataract followed later by posterior segment surgery; or it may be done in a single session: i.e., combined surgery of both the anterior and posterior segments. OBJECTIVE: To evaluate the outcomes of combined surgery by phacoemulsification and vitrectomy. METHODS: We retrospectively reviewed the records of 42 patients with coexisting cataract and vitreoretinal disease who underwent combined surgery by phacoemulsification and pars plana vitrectomy at one session. RESULTS: Indications for surgery were vitreous hemorrhage in 71.4%, retinal detachment in 11.9%, macular hole in 11.9%, and epiretinal membrane in 4.8%. There were no significant intraoperative complications. The main early postsurgical complications were fibrinous formation in 11.9%, elevated intraocular pressure in 23.8%, and recurrent vitreous hemorrhage in 9.5%. There were a few late complications related to phacoemulsification: posterior synechia in 9.5%, posterior capsular opacification in 7.1%, and dislocating intraocular lens in 4.8%. Recurrent retinal detachment occurred in five eyes and rubeoisis iridis in one. Visual acuity was improved in 85.8%, stable in 7.1% and worse in 7.1%. CONCLUSIONS: Phacoemulsification performed at the time of posterior segment surgery enables good visualization during the vitrectomy, facilitates surgery, and is associated with only minor complications. In cases with cataract and vitreoretinal diseases, combined surgery by phacoemulsification and vitrectomy in one session may be considered.

Confusion/delirium following cataract surgery: an incidence study of 1-year duration.

BACKGROUND: Delirium is frequently observed in clinical practice, particularly in medical and surgical wards and more so among patients at risk, especially elderly with preexisting central nervous system impairments. OBJECTIVE: Despite the severe consequences of delirium, epidemiological data relating to incidence of delirium following "minor" surgery are lacking. The aim of the present study was to evaluate the incidence of delirium following cataract surgery in community-dwelling patients. OUTCOME: For purposes of the present study, the Confusion Rating Scale was used. RESULTS: Of 296 patients fulfilling the inclusion criteria, 13 (4.4%) had had immediate postoperative delirium. The two variables that significantly differentiated between delirious and nondelirious patients were older age (82.1 vs. 73.06 years; p < .001) and more frequent use of benzodiazepine premedication (69% vs. 39.9%; p < .002). CONCLUSION: These findings suggest that the incidence of delirium following cataract surgery requires greater awareness, possibly changes in premedication, and a longer observation period in the very old.