Rebubbling of detached descemet membrane endothelial grafts at the slit lamp with 50% air fill after PI-less DMEK during COVID-19 era

Transcriptomic responses to antibiotic exposure in Mycobacterium tuberculosis

Transcriptional responses in bacteria following antibiotic exposure offer insights into antibiotic mechanism of action, bacterial responses, and characterization of antimicrobial resistance. We aimed to define the transcriptional antibiotic response (TAR) in Mycobacterium tuberculosis (Mtb) isolates for clinically relevant drugs by pooling and analyzing Mtb microarray and RNA-seq data sets. We generated 99 antibiotic transcription profiles across 17 antibiotics, with 76% of profiles generated using 3-24 hours of antibiotic exposure and 49% within one doubling of the WHO antibiotic critical concentration. TAR genes were time-dependent, and largely specific to the antibiotic mechanism of action. TAR signatures performed well at predicting antibiotic exposure, with the area under the receiver operating curve (AUC) ranging from 0.84-1.00 (TAR <6 hours of antibiotic exposure) and 0.76-1.00 (>6 hours of antibiotic exposure) for upregulated genes and 0.57-0.90 and 0.87-1.00, respectfully, for downregulated genes. This work desmonstrates that transcriptomics allows for the assessment of antibiotic activity in Mtb within 6 hours of exposure.

A Simple Repair Algorithm for Descemet's Membrane Detachment Performed at the Slit Lamp

Our study aims to investigate a simple repair algorithm for Descemet's membrane detachment (DMD) following phacoemulsification with Pentacam and anterior segment optical coherence tomography (AS-OCT). Twelve patients with DMD were included in this retrospective study. All cases had persistent corneal edema after phacoemulsification and no improved response to conservative treatment. The repair algorithm consisted of delineating the DMD with the Pentacam and AS-OCT, paracentesis, and intracameral air bubble performed at the slit lamp, followed by immediate supine position. At one month, the final status of Descemet's membrane (DM), best-corrected visual acuity, and incidence of complications were noted. DMD was involved in the visual axis in all cases. The mean interval between phacoemulsification and repair was 5.3 ± 1.2 days. Complete reattachment of DM and corneal clarity occurred in all 12 eyes. Eleven (91.7%) eyes underwent one repair procedure, while one eye (8.3%) underwent a repeat procedure. No adverse events were found. Minor post-intervention complications included temporary increased intraocular pressure due to pupillary block in one eye (8.3%). In conclusion, our modified and simplified repair algorithm for DMD can be performed safely as an outpatient procedure, with accurate delineation using a Pentacam and AS-OCT. It may provide new insight into the timely diagnosis, evaluation, and management of DMD.