13.3 Medical Retina – Age-Related Macular Degeneration (AMD)
13.4 Medical Retina - Diabetes
13.5 Medical Retina – Retinal Vein Occlusion (RVO)
13.6 Vitreoretinal Surgery
13.11 Ocular Oncology
Intracameral cefuroxime decreased risk of endophthalmitis by 5x
Risk higher if male, CCI (c.f. scleral tunnel), & silicone IOL
Use of perioperative levofloxacin drops as prophylaxis was associated with reduction in endophthalmitis, although not statistically significant
Four groups studies – no drops/injection, intracameral, drops/no intracameral, drops and intracameral (lowest rate of endophthalmitis)
Barry, P., Seal, D.V., Gettinby, G. et al. 2006. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 32(3) 407-410.
If VA LP at presentation endophthalmitis, do better with initial vitrectomy rather than intravitreal antibiotics (3x increased chance of achieving 6/12)
IV antibiotics make no difference
Very old study, may not be applicable today, high rate of endophthalmitis in study, multiple problems with protocol)
1995. Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis. Endophthalmitis Vitrectomy Study Group. Arch Ophthalmol 113(12) 1479-1496.
Comparison of topical NSAIDs, topical steroids, or both in prevention of post-op CMO in uncomplicated cataract surgery. Findings – patients receiving combination bromfenac (0.09%) BD for 3/52 combined with dexamethasone 0.1% for 4/52 had lower risk of developing post-op CMO
Wielders, L.H.P., Schouten, J.S.A.G., Winkens, B. et al. 2018. European multicenter trial of the prevention of cystoid macular edema after cataract surgery in nondiabetics: ESCRS PREMED study report 1. Journal of Cataract & Refractive Surgery 44(4).
Diabetics randomised to no additional treatment, subconjunctival 40mg triamcinolone, intravitreal bevacizumab (IVB), or combination post-cataract surgery (all patients received topical bromfenac and dexamethasone). Patients receiving subconjunctival triamcinolone has lower central macular thickness (CMT) and no CMO. IVB had no significant effect
Wielders, L.H.P., Schouten, J.S.A.G., Winkens, B. et al. 2018. Randomized controlled European multicenter trial on the prevention of cystoid macular edema after cataract surgery in diabetics: ESCRS PREMED Study Report 2. Journal of Cataract & Refractive Surgery 44(7).
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Vitreoretinal Surgery Online
This open-source textbook provides step-by-step instructions for the full spectrum of vitreoretinal surgical procedures. An international collaboration from over 90 authors worldwide, this text is rich in high quality videos and illustrations.