RESUMEN
A survey of randomly selected ophthalmic outpatient surgical facilities revealed a lack of established investigative protocols to follow when postoperative endophthalmitis occurs. The survey also provided information about the incidence of endophthalmitis, the microorganisms encountered, and the precautions used to prevent postoperative infections. We present an endophthalmitis investigative protocol which provides a task list, investigation forms, incidence log, and quality assurance measures to identify patients at risk and to minimize the risk of recurrence of this rare but serious complication of ophthalmic surgery. This standardized protocol will also assist in source identification when aseptic iritis occurs postoperatively. The purpose of this paper is to stimulate a dialogue which may result in an international standard for an endophthalmitis investigative protocol.
Asunto(s)
Protocolos Clínicos , Endoftalmitis/prevención & control , Infecciones Bacterianas del Ojo/prevención & control , Complicaciones Posoperatorias/prevención & control , Procedimientos Quirúrgicos Ambulatorios , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/prevención & control , Extracción de Catarata/efectos adversos , Endoftalmitis/epidemiología , Infecciones Bacterianas del Ojo/epidemiología , Humanos , Incidencia , Distribución Aleatoria , Encuestas y Cuestionarios , Estados Unidos/epidemiologíaRESUMEN
A cadaver eye model was used to evaluate and quantify the use of thermokeratoplasty for steepening the central cornea to correct hyperopia. Four groups of eye-bank eyes were treated with four separate surgical plans. Each plan involved the placement of controlled thermal burns (in the depths of the corneal stroma, using a cautery probe) applied in a radial pattern up to a premarked optical zone. The plans differed in the sequence of surgical steps. All plans progressively added radials and applications (to decrease optical zone) in various sequences. Corneal curvature was measured at baseline and at each surgical step. As more surgery was done within each plan, the corneas became progressively steeper. Total mean changes in corneal curvature ranged from 16.26 diopters to 19.76 diopters, depending on the plan. At each optical zone, as the number of radials increased, the effect increased. With progressively smaller optical zone size, the effect also increased.