There’s absolutely no way Media MICE could attend a major ophthalmological conference and not completely fanboy over some of the best posters available on demand. That would be like eating french fries without ketchup (or mayonnaise in some parts), or like Media MICE CEO Matt Young going to a conference without dressing in an over-the-top suit — it just wouldn’t be the same. So, while covering the 52nd Annual Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists (RANZCO Brisbane 2022), we knew we had to whip up an article covering some of the most outstanding anterior segment posters.
Kudos for the Crosslinking
Let’s start with a Case Report of Successful Corneal Crosslinking in a Patient with Corneal Ectasia Associated with Stevens-Johnson Syndrome (SJS) by researchers based at the University of Auckland (New Zealand). They reported an unusual case of a 25-year-old Indian male who presented with a three-year history of progressively deteriorating visual acuity in the left eye with a history of SJS, causing corneal conjunctival epithelial desquamation, pseudomembrane formation, and excessive eye rubbing. Visual acuity in the left eye was 6/120 with increasing levels of astigmatism.
The Kiwi researchers examined the patient with serial corneal tomography. It was found that he was affected by progressive inferior corneal steepening, and thinning and abnormal posterior elevation consistent with a diagnosis of corneal ectasia. The patient then underwent accelerated epithelium-off crosslinking with four minutes of continuous ultraviolet-A exposure at 30 mW/cm2 and a total energy dose of 7.2 J/cm2. You’ll be pleased to learn that re-epithelization was observed within 72 hours post-crosslinking with no complications. Concluding, the researchers reported that accelerated epithelium-off crosslinking was a good treatment when combined with ocular surface pre-optimization and vigilant postoperative monitoring.
Do you want to know how I got these scars?
Now, there wasn’t anything specifically about syphilis this time around (much to one writer’s horror and the absolute relief of the rest of the team), so we settled for the next best thing: We examined a poster about herpes. Titled Cataract Surgery in Herpes Simplex Virus (HSV) Ocular Disease, and researched in Auckland by the city’s health board, the poster examined clinical records of patients diagnosed with HSV-related keratitis and/or anterior uveitis who underwent subsequent cataract surgery. All in all, 37 eyes of 37 patients were examined, with intraoperative complications occurring in one subject (2.7%), specifically iris prolapse.
Of the rest of the patients, keratitis or uveitis recurred postoperatively in 17 subjects (45.9%), with 22.5% experiencing recurrence in the first year following surgery. One case of postoperative cystoid macular edema (2.7%) and one case of postoperative endophthalmitis (2.7%) occurred.
Corrected distance visual acuity at 3 months was >20/50 in 21 subjects (70.0%), 20/50 to 20/200 in four subjects (12.9%), and ≤20/200 in six subjects (19.4%). Vision improved in 26 eyes (83.9%) and worsened in one eye (3.2%). In their concluding remarks, the authors of the study said that cataract surgery in eyes with prior HSV disease can improve visual acuity but one’s prognosis must be guarded, especially in eyes with corneal scarring.
Inflamed in the Membrane
Nobody likes to undergo serious complications after surgery. So, a poster titled Is Zero Incidence of PostOperative Endophthalmitis after Cataract Surgery Achievable? really caught our attention. Postoperative endophthalmitis (POE) is defined as severe inflammation involving both the anterior and posterior segments of the eye after intraocular surgery. And indeed, there were no cases for over 10 years following cataract surgery at Chatswood Private Hospital (Chatswood, Australia) where the researchers were based. They examined data on cataract surgery cases between the years 2010-2020 to understand how they achieved a zero infection rate over the period.
In total, 28,937 cataract surgery cases were examined and the authors found that the intracameral route for antibiotic prophylaxis was more commonly used, compared to subconjunctival or both. This led them to conclude that the administration of prophylactic antibiotics, regardless of the route of administration, is beneficial and equally effective in preventing POE. They also noted that using ophthalmology-only operating theaters is a good practice, and after all, having your own space is always a blessing.
Editor’s Note: The 52nd Annual Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists (RANZCO Brisbane 2022) was held virtually from February 26 to March 1. Reporting for this story took place following the event.
