Postphacoemulsification endophthalmitis--role of residual debris in the handsets used for surgery

A study on the incidence, microbiological analysis and investigations on the source of infection of postoperative infectious endophthalmitis in a tertiary care ophthalmic hospital: an 8-year study

Background:

The objective of the study was the determination of the incidence of culture-proven postoperative endophthalmitis and probable sources of infection.

Materials and Methods:

It was a prospective study on the microbiology, incidence and probable sources of infection in patients with postoperative infectious endophthalmitis carried out in a tertiary care eye hospital. Consecutive patients diagnosed with postoperative infectious endophthalmitis during the years 2000-2007 were investigated for the causative infective agent and possible sources of infection. The surgical data and microbiological data including the investigations performed to trace the source were recorded in a specific formatted form and were gathered and compiled for analysis.

Results:

Data of analysis showed that 98 (0.042%) out of 2,31,259 patients who underwent intra-ocular surgery developed infectious endophthalmitis. Among these, 70 (0.053%) occurred after cataract, 10 (0.5%) after penetrating keratoplasty (PK) and 18 (0.018%) following other types of intra-ocular surgeries. The predominant infectious agents isolated were bacteria (89.7%), with equal proportions of Gram-positive and Gram-negative bacteria. Polymicrobial infection was noted in four and fungi in seven patients. Occurrence of postoperative endophthalmitis was sporadic and not related to any specific part of period in a year. Sources of infection were donor corneal rim in six post-PK patients and phaco probe in one who had postphacoemulsification endophthalmitis

Conclusions:

Overall incidence of postoperative endophthalmitis over an 8-year period was quite low. The sources of infection could be established in six post-PK endophthalmitis patients and in a postcataract surgery.

Insulin glargine and glulisine SoloSTAR pens for the treatment of diabetes

Insulin is an effective medication for lowering hemoglobin A(1c) values and can be used for both basal and prandial coverage of hyperglycemia in Type 1 and Type 2 diabetes. Despite its effectiveness there is still reluctance by patients and physicians to add insulin into the treatment regimen for Type 2 diabetes when needed. One of the key barriers to initiating insulin therapy is the method of delivery. Insulin delivery pens are continually developed as a means to improve upon the vial and syringe and to make it easier for patients to incorporate insulin therapy into their lifestyles. The SoloSTAR pen (Sanofi-Aventis, Paris, France) was developed to make insulin delivery easier and to help eliminate barriers to the initiation of insulin therapy. In this article, we discuss the features and characteristics of SoloSTAR that overcome existing unmet needs.