Eyeworld

MAR 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/78716

Contents of this Issue

Navigation

Page 98 of 167

March 2012 Tears Again advanced Liposome Spray ® RECOMMENDED FOR MGD As seen in The International Workshop on Meibomian Gland Dysfunction mycobacterial infections, there aren't necessarily clinical signs to point the way to a diagnosis. In- stead, it is more what isn't happen- ing that is indicative. "If a patient is presenting with an infection that seems to be recalcitrant to typical antimicrobial therapy, if it's a pro- longed time, that really should alert you to mycobacterial infection," Dr. Girgis said. If after culture it is determined to be a mycobacterial infection, treatment needs to be tailored ac- cordingly. Typically, Dr. Girgis finds that such infections are the result of mycobacterial abscesses and che- lonae, which were sometimes com- bined. "They were most susceptible to amikacin and clarithromycin and less sensitive to the quinolones and linezolid," Dr. Girgis said. Even the amikacin and clar- ithromycin, which were often used together, may not be enough. "In our study, 69% of patients required some kind of surgical intervention in order to help with resolution of the infection," Dr. Girgis said. That could involve anything from simple amputation of a LASIK flap to the need for penetrating keratoplasty. "Surgical intervention was the hall- mark in almost 70% of those eyes in addition to prolonged therapy with these antimicrobial agents," she said. "The average time that it took between when the infection was di- agnosed to when it cleared in our study was about 146 days." Overall, Dr. Girgis hopes that practitioners keep the idea of my- cobacterial infection at the forefront when facing a challenging case. "I think that the take-home is prompt recognition of the fact that my- cobacteria should be on your differ- ential diagnosis, particularly in an infection that's not clearing or that seems to be prolonged and or associ- ated with a biomaterial," she said. Secondly, she urged prompt Gram- staining culture analysis to try to identify the species, and once a my- cobacterial infection is identified, recognition of the fact that removal of any biomaterial as well as possible surgical intervention may be neces- sary. EW Editors' note: Dr. Girgis has no financial interests related to this article. Contact information Girgis: 504-621-7683, dgirgis@uwhealth.org Improv ves TBUT and T T ear Fi Film Stability Save the Date! Saturday, April 21, 2012 7:00 – 9:30 AM McCormick Place 2012 ASCRS•ASOA Symposium and Congress www.eyeworld.org CME credit is not available for Corporate Mornings programs. *Nichols KK, Foulks GN, Bron AJ, Glasgow BJ, Dogru M, Tsubota K, Lemp MA, Sullivan DA. The International Workshop on Meibomian Gland Dysfunction, Investigative Ophthalmology & Visual Science, Special Issue 2011, Vol. 52, No. 4 © 2011 OCuSOFT, Inc. Rosenberg, TX 77471 "Dry Eye sufferers (particularly those with lipid deficiency) and Meibomian Gland Dysfunction patients do very well with Tears Again [advanced Liposome] Spray. Individuals that have difficulty instilling eye-drops should also be considered." Marguerite McDonald, MD, FACS For FREE samples and more information, call (800) 233-5469 or visit ASCRS Booth #1101 www.tearsagainspray.com OCuSOFFT OCuSOFT Lid Scrub Eyelid Cleansers Ideal to Use in ConjuIIdeal to Use in Conjunction with ® T ® Eyeli unction with id Cleansers Improves TBUT and Tear Film Stability So Soothes, Moisturizes and Protects oothes, Moisturizes and Protects and Protects Available at CVS pharmacy ay

Articles in this issue

Links on this page

Archives of this issue

view archives of Eyeworld - MAR 2012