Endophthalmitis caused by streptococcal species.

The medical records of 48 patients with culture-positive streptococcal endophthalmitis diagnosed between January 1977 and May 1990 were reviewed. The viridans group streptococci were isolated in 24 (50%) of the 48 cases, enterococci in 13 cases (27.1%), Streptococcus pneumoniae in six cases (12.5%), and beta-hemolytic streptococci in six (12.5%) of 48 cases. The clinical statuses of endophthalmitis cases by etiology were postoperative in 40 patients (83.3%), posttraumatic in six patients (12.5%), and miscellaneous in two patients (4.2%). Overall, 15 (31.2%) patients achieved 20/400 or better visual acuity. The streptococcal isolates demonstrated a 32.6% in vitro resistance to gentamicin sulfate, whereas all isolates were sensitive to vancomycin hydrochloride. The enterococci were often resistant to the cephalosporins, whereas the other streptococcal species were not.

Endophthalmitis caused by Staphylococcus aureus.

The medical records of 27 patients (27 eyes) with culture-positive Staphylococcus aureus endophthalmitis, diagnosed between December 1984 and February 1992, were reviewed. In 20 of the 27 eyes, endophthalmitis occurred within seven days of ocular surgery. All tested isolates were sensitive to vancomycin, gentamicin, and ceftazidime. In 13 eyes treated by initial vitrectomy and intraocular antibiotic injection, ten eyes achieved 20/400 or better visual acuity, compared to seven of 14 eyes in the initial vitreous tap and intraocular antibiotic injection group. For the eight eyes treated initially with intraocular corticosteroids, seven eyes achieved 20/400 or better visual acuity, compared to ten of 19 eyes in the group receiving no initial intraocular corticosteroids (P = .190). The use of vitrectomy and intraocular corticosteroids with intraocular antibiotics was associated with the best visual outcomes in this group of eyes with endophthalmitis caused by S. aureus.

Correlation between intraocular pressure control and progressive glaucomatous damage in primary open-angle glaucoma.

Fifty-five patients with primary open-angle glaucoma and early glaucomatous damage who had medical therapy and laser trabeculoplasty were followed up for four to 11 years or until progressive glaucomatous damage was documented. Factors associated with the stability or progression of glaucoma were evaluated. Eyes with mean intraocular pressure higher than 21 mm Hg during the follow-up period uniformly had progressive glaucomatous changes. Conversely, eyes with mean intraocular pressure less than 17 mm Hg remained stable, and approximately half of the eyes with mean intraocular pressure between 17 and 21 mm Hg had progressive glaucomatous changes. Patients who remained stable were slightly younger than those with progressive glaucomatous changes (P less than .05), but initial optic nerve head appearance, initial visual field findings, number of medicines used, medical history, and patient gender or race were not statistically associated with stability or progression of the glaucoma. These findings reinforce the importance of intraocular pressure control in primary open-angle glaucoma and the need to identify other markers that help determine the proper level of intraocular pressure for individual patients.

'Very late onset' cystoid macular edema.

Cystoid macular edema typically manifests 4 to 16 weeks after ocular surgery. It has only rarely been documented with an onset more than 2 years postoperatively. We report four patients who developed clinically significant cystoid macular edema between 7 and 16 years after initially successful surgery. Two patients had undergone intracapsular cataract extraction, one extracapsular cataract extraction, and one a scleral buckling procedure. Although such cases of "very late onset" cystoid macular edema are uncommon, it should be considered in patients who suffer visual loss many years after ocular surgery.

Effects of various concentrations of native seminal plasma in cryoprotectant on viability of human sperm.

To investigate the effect of native seminal plasma on the recovery of frozen human sperm, various concentrations of seminal plasma (0, 25, 50, 75, and 100%) were used in cryoprotectant for freezing sperm, and the viabilities of frozen-thawed sperm were compared. The post-thaw sperm motility of 50 or 75% seminal plasma in the fertile group was significantly higher than that of 0, 25, or 100%. The post-thaw motility of 75% donor seminal plasma in the patient group was higher than that of other concentrations. It was suggested that a certain concentration of native seminal plasma in cryoprotectant would be helpful to the viability of human sperm cryopreservation.