Endophthalmitis After Artisan Phakic Intraocular Lens Implantation for Correction of High Myopia

Comparison of Corneal Diameter and Anterior Chamber Depth Measurements Using 4 Different Devices

PURPOSE

To evaluate the reliability and validity of anterior chamber depth (ACD) and corneal diameter [white-to-white (WTW) distance] measurements with 4 devices as well as applicability of these values in predicting the anterior chamber angle diameter evaluated by optical coherence tomography for implantation of lenses in the anterior chamber.

METHODS

In this prospective randomized case series, we measured ACD and WTW distance in one eye of 40 healthy subjects with Pentacam HR, IOL Master 500, LenStar 900, and Visante OCT.

RESULTS

When comparing WTW distance with anterior chamber angle diameter measured by Visante OCT coefficient of repeatability and limits of agreement ranges were 0.5 and 1.1 mm for IOL Master, 0.5 and 1.1 mm for Pentacam HR, and 0.6 and 1.1 mm for LenStar (P < 0.05 in all cases), respectively. Coefficient of repeatability and limits of agreement ranges were 0.3 and 0.6 mm for IOL Master, 0.3 and 0.5 mm for Pentacam HR, and 0.3 and 0.6 mm for LenStar, respectively, compared with ACD measured by Visante OCT; however, P was not significant in any of the cases. P value was also not significant when comparing IOL Master, LenStar, and Pentacam in terms of ACD and WTW distance with each other.

CONCLUSIONS

Unlike previous groups analyzing the ACD and WTW distance we found no significant difference between the measurements by different automatic devices. We consequently expect no difference in clinical outcome when measurements for WTW distance or ACD are performed with any of the devices listed above.

Streptococcus mitis/oralis endophthalmitis management without phakic intraocular lens removal in patient with iris-fixated phakic intraocular lens implantation

Background

To report a case of Streptococcus mitis/oralis endophthalmitis management which had developed after complicated iris-fixated phakic intraocular (pIOL) lens implantation.

Case presentation

A 23-year-old-woman received pIOL implantation followed secondary intraocular intervention to lower intraocular pressure. The patient presented with severe pain and decreased visual acuity and was managed with intravitreal and intracameral antibiotic injection with topical applications of fortified antibiotics. Culture of aqueous humor was positive for S. mitis/oralis, which was sensitive to the empiric antibiotic regimen. Clinical features started to improve 5 days after treatment and the pIOL was left in place. The uncorrected distant visual acuity and endothelial cell count were 20/32 and 3143cells/mm² four weeks after treatment, respectively.

Conclusion

S. mitis/oralis endophthalmitis after pIOL implantation could be managed with appropriate antibiotic administration without pIOL removal if accompanied by rapid clinical improvement after the initial intensive management in the absence of vitreous involvement.