GRAND WARD ROUND Dr Heng Li Wei Dept of Ophthalmology, TTSH 23rd May 2007 History Mdm F.L.T., 66yo/C/F PMH: Asthma Ocular history: Left Phaco/IOL 26/3/04 Right Phaco/IOL 3/5/04 Presented on 1/2/07 c/o: - Right eye pain a/w tearing, itch x 1 day - No hx of trauma.
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Dr Heng Li Wei
Dept of Ophthalmology, TTSH
23rd May 2007
Right Phaco/IOL 3/5/04
- Right eye pain a/w tearing, itch x 1 day
- No hx of trauma.
-> deemed unfit for GA.
Cornea abscess at stitch site 1.5mm.
New stitch post-op at 12 o’clock position.
AC cells 4+, fibrin +, hypopyon present.
No view of posterior pole.
G cefazolin 50mg/ml Q1H
G gentamicin 14mg/ml Q1H
G atropine bd
G cefazolin Q1H, G ciloxan Q1H.
Endogenous vs Exogenous
1. Early vitrectomy & intravitreal antibiotics vs
2. Vitreous tap/biopsy & intravitreal antibiotics
In addition, all eyes randomised to treatment with or without IV antibiotics
- location of bleb ( inferior)
- late onset bleb leakage
- ? use of anti-fibrotic agents
Average postop time til infection – 24.7 mths
(Late-onset blebitis/endophthalmitis: incidence and outcomes with mitomycin C.Optom Vis Sci. 2004 Jul;81(7):499-504.)