OCT 2013

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

Issue link: https://digital.eyeworld.org/i/194331

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Page 112 of 134

October 2013 110 EW MEETING REPORTER continued from page 108 Avoiding endophthalmitis Pre- and postop fluoroquinolone combined with 5% povidone-iodine is the best combination to reduce ocular surface flora for intraocular surgery, according to a speaker at the meeting. "The goal of surgical prophylaxis is to prevent pathogenic organisms from entering the eye during or after ocular surgery," said Jose Beniz Neto, MD, Brazil. To prevent endophthalmitis, he recommended the following: • Treat pre-existing periocular infections; • Administer antibiotics 1–2 days before surgery and immediately preop; • Use 5% povidone-iodine five minutes before surgery; • Keep eyelashes and lids separated with a plastic drape; LET'S TALK SOLUTIONS The Complete Biometry Solution Help to ensure accuracy* and improve efciency with the new A-Scan Plus Connect®. The Connect ultrasound biometer provides a data link to the ZEISS IOLMaster® 500 for seamless workflow integration. The universal ultrasound interface of the IOL aster allows for quick and easy data transfer between the IOLMaster 500 and theA-Scan Plus Connect. • Decrease intraoperative fluids in fornix; • Avoid IOL contact with the ocular surface and adnexa; • Ensure good wound closure; and • Start topical fluoroquinolone immediately after surgery. Still no clear answer on steroids Alejandro Lichtinger, MD, Canada, presented his findings of a study to determine if topical steroids were beneficial in the treatment of bacterial keratitis. Dr. Lichtinger undertook an exhaustive study of the current literature on the subject and only found four relevant randomized trials that were "underpowered" and had other bias issues, he said. Dr. Lichtinger said there might be a role for steroids in certain types of ulcers, depending on the location, severity, and microorganism, but it's hard to tell which ulcers would definitely benefit. "The use of topical steroids as an adjuvant to topical antibiotics seems to be safe, but we don't have a consensus on this topic yet," Dr. Lichtinger concluded. "We definitely don't know how to identify which cases need steroids yet. We need more research to find out." In the meantime, "we should culture patients and get a bacterial diagnosis before we administer steroids," Dr. Lichtinger said. Treating fungal keratitis Accutome, Keeler, Volk AAO Booth #2245 Three great companies combining to provide a wide array of products and the best customer experience. #24-4400 * Haigis W, Mlynski J, Comparative axial length measurements using optical and acousticbiometry in normal persons and in patients with retinal lesions,White Paper, Carl Zeiss Meditec, 2009 www.accutome.com/product/connect 3222 Phoenixville Pike, Malvern, PA 19355 USA • 800-979-2020 • 610-889-0200 • FAX 610-889-3233 • www.accutome.com The data keeps updating on how to treat fungal keratitis, said one speaker at the meeting. "What I am going to present you is for today. Tomorrow it might change," said Eduardo Alfonso, MD, Miami. In one phase 3, double-masked, multicenter trial, 368 patients either used voriconazole (1%) or natamycin (5%) applied topically every hour while awake until re-epithelialization, then four times daily for at least five weeks. Eligibility for the trial included a smear-positive filamentous fungal ulcer and a visual acuity of 20/40 to 20/400. Researchers found that the natamycin group had significantly

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