Efficacy of intravitreal povidone-iodine administration for the treatment of Candida albicans endophthalmitis in rabbits.

This study aimed to investigate the efficacy of intravitreal povidone-iodine (PI) administration for the treatment of Candida albicans endophthalmitis. Forty New Zealand white rabbits were divided into four groups (n = 10 per group). After the induction of endophthalmitis using Candida albicans, groups A, B, and C received single intravitreal injections of 0.035 mg voriconazole, 0.3 mg PI, and their combination, respectively. Rabbits that were administered sham injections were in group D as controls. Fundus photography, vitreous culture, electroretinography (ERG), and histologic examinations of the retina were conducted on day 7. The anterior chamber flare (grade 0 to 4), severity of iritis (grade 0 to 4), and vitreous opacity (grade 0 to 3) were scored. Candida albicans was cultured in the vitreous sample. On day 7, the vitreous opacities were found in all groups. Compared to that in group D, groups A, B, and C showed a lower score for flare (p < 0.001) and iritis (p < 0.001) and less fungal growth in the vitreous culture (n = 2, 1, 1, and 10 in groups A, B, C, and D, respectively; p < 0.001). Furthermore, ERG and histologic findings demonstrated less affected a- and b-waves and damaged retinal tissues in groups A, B, and C. However, these findings were not different among groups A, B, and C. PI significantly improved Candida albicans endophthalmitis, and the effect was comparable that of the voriconazole, although some vitreous opacities remained. No synergistic effect of the combination of PI and voriconazole was observed. Intravitreal PI may be useful to treat Candida albicans endophthalmitis.

Relationship Between Visual Acuity and Corneal Curvature Change in Children After Epiblepharon Surgery.

PURPOSE: To determine the relationship between visual acuity and corneal curvature change in children after epiblepharon correction surgery by corneal topography. METHODS: The authors retrospectively reviewed the data of 62 children (121 eyes) who had epiblepharon surgery. The authors measured keratometric values of corneal curvature for 2 corneal zones: central 3 and 5 mm zone. Two zones were classified into 4 areas, including nasal, superior, temporal, and inferior area. Visual acuity and keratometric values were estimated preoperatively and at 1, 3, and 6 months postoperatively. The authors analyzed the correlation between visual acuity and corneal curvature change in 4 areas of the 2 zones. RESULTS: There were statistically significant differences between preoperative and postoperative visual acuity 1 month after surgery. At postoperative 3 months, the inferior and superior areas of the 3 mm corneal zone were much flatter than before surgery (P < 0.05). Corneal curvature only at the inferior area of the 3 mm zone had significantly a negative correlation with postoperative visual acuity at 3 and 6 months (r =  -0.275, P = 0.02 and r = -0.351, P = 0.01, respectively). However, visual acuity had no significant correlation with corneal curvature change in any of the areas of the 5-mm corneal zone. CONCLUSIONS: The authors found that corneal curvature has significantly become flattened in the superior and inferior areas of the 3 mm corneal zone, postoperatively. Furthermore, inferior area in the 3 mm corneal zone affected only on the visual acuity improvement after postoperative 3 months.

Porous Polyethylene Implant Associated With Delayed Orbital Complications and Osteomyelitis After Orbital Reconstruction.

Orbital implants are commonly used to repair orbital blowout fractures, to restore the functional and anatomical structure of the orbit. Porous polyethylene implants are a type of alloplastic implant and are widely used for orbital reconstruction as micropores facilitate the growth of fibers and blood vessels through the material. Rare complications associated with porous polyethylene implants used to treat blowout fractures include delayed orbital inflammation and osteomyelitis. The authors describe a 68-year-old man who presented with a 5-year delayed porous polyethylene implant infection and cicatricial ectropion with osteomyelitis after an orbital blowout fracture repair. The patient underwent surgery to incision and drainage of orbital abscess with ectropion correction surgery. He was treated with intravenous antibiotics for 6 weeks due to osteomyelitis and made a good recovery.