Eyeworld

EW CATARACT 28 topical gel or liquid medication prior to cataract surgery. Dr. MacDonald: This study challenges the assumption that lidocaine gel serves as a barrier to povidone-iodine. It shows that there is no statistically signifi cant difference in colony forming units after povidone-iodine antisepsis in patients treated with topical gel or liquid medication prior to cataract surgery. In-the-bag IOL dislocation: Comparison of presentation characteristics and surgical outcomes in eyes with and without CTR Betty Lorente, MD Purpose: To evaluate the presenta- tion characteristics and surgical outcomes of late in-the-bag IOL dislocation and to compare cases with and without capsular tension ring (CTR) within the capsular bag. Methods: Retrospective (2005– 2009)/prospective (2010–2013) inter- ventional case series including cases of late spontaneous in-the-bag IOL dislocation from two referral centers. The main outcome measures were interval between surgery and dislo- cation, dislocation site/grade, type of IOL, associated CTR, predisposing factors, surgical technique used to correct dislocation (repositioning using scleral fi xation [SFIOL]), iris suturing, IOL exchange for anterior chamber IOL (ACIOL), or iris-claw IOL (ICIOL), IOL removal and anterior capsulotomy), preoperative/ postoperative corrected distance visual acuity (CDVA), and surgical complications. Results: 105 cases of in-the-bag IOL dislocation were identifi ed. Most common risk factor: pseudoexfoli- ation. CTR in the capsular bag: 21 Methods: Prospective, masked, randomized controlled trial of 104 patients. Sample size calculation was performed. Patients presenting for uncomplicated cataract surgery were included if they were able to give informed consent. Exclusion criteria included hypersensitivity to study medications. One hour prior to surgery, patients were randomized to gel composed of lidocaine, cyclopentolate, phenylephrine, diclofenac, and moxifl oxacin, or to the above medications in liquid form. In the operating room, the periocular skin was cleansed with 10% povidone-iodine and the eye with 5% povidone-iodine. The con- junctiva was swabbed and plated. Colony forming units were read by masked microbiology readers. Re- gression analysis was performed. Results: One hundred four eyes of 101 patients were included. Fifty-two eyes were randomized to gel and 52 to liquid drops. Prior to randomization, there were no signifi cant differences in mean colony forming units (CFU) on blood or chocolate agar between the groups (p=0.3197 for both). Post povidone-iodine, mean CFUs were 1.92 in both groups on both blood and chocolate agar. Multiple linear regression analysis to compare between the groups with post povi- done-iodine CFUs as the outcome variable and controlling for pre-ran- domization CFUs revealed no signifi - cant difference between the groups on blood or chocolate agar (p=0.989 for both). Conclusion: This prospective, masked, randomized controlled trial evidences that there is no statistical- ly signifi cant difference in colony forming units after povidone-iodine antisepsis in patients treated with Randomized controlled trial of effi cacy of povidone-iodine in reducing bacterial load prior to surgery after premedication with gel versus drops Joshua C. Teichman, MD, MPH, FRCSC, and colleagues Purpose: Recent laboratory studies suggest that the antiseptic effect of povidone-iodine may be inhibited by application of gels to the eye, in- cluding lidocaine, as may commonly be used prior to cataract surgery. No clinical studies have been per- formed. The purpose of this study is to elucidate if this is seen clinically. Susan M. MacDonald, MD, highlighted the best cataract papers at the "Hot Off the Press" session at the 2014 ASCRS•ASOA Symposium & Congress. The papers were chosen from the 2014 ASCRS Best Paper of Session winners. Here are the abstracts from the studies, with her comments regarding selection. Hot off the press: September 2014 Dr. MacDonald highlights the best cataract papers at the "Hot Off the Press" session. Source: EyeWorld Third in a series of 5 presentations

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