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EPIDEMIOLOGY: Infectious Disease Risk Factors of Corneal Graft Donors
Objective  To determine how donor health status affects the risk of infection after corneal transplant. Methods  An adverse reaction surveillance registry was used to conduct a matched case-control study among transplanted donor corneas from January 1, 1994, to December 31, 2003. Cases comprised 162 reports of endophthalmitis after penetrating keratoplasty including 121 with microbial recovery, of which 59 had concordant donor and recipient microbial isolates. Two controls were matched to each case by surgery date. Conditional logistic regression estimated adjusted odds ratios with 95% confidence intervals according to the premortem status of decedent donors. Results  Postkeratoplasty endophthalmitis was associated with recent hospitalization (odds ratio, 2.84; 95% confidence interval, 1.61-4.98) and fatal cancer (odds ratio, 2.46; 95% confidence interval, 1.53-3.97) among donors. Endophthalmitis appeared more likely with tissues transplanted longer than 5 days after donation (odds ratio, 1.55; 95% confidence interval, 1.02-2.35). The prevalence of concordant microbial isolates from donors and recipients was greater among fungal endophthalmitis than among bacterial endophthalmitis (P < .001). Conclusions  Corneal grafts with eye tissue obtained from donors dying in the hospital or with cancer may have an increased risk of postsurgical endophthalmitis, possibly due to donor-to-host microbial transmission. Together with donor screening and processing, improvements in microbiological control may reduce infection associated with corneal transplant.
Source: archopht.ama-assn.org

NEWS AND COMMENT: February 2008

Source: archopht.ama-assn.org

Eye Care Products: An Entire Range to Choose from!
Buy eye care products from Amazon’s secure Eye Care Store. You can be sure you are buying quality stuff, if you are buying it from Amazon!
Source: www.thirdeyehealth.com

Third Eye Chakra: Ajna - The Sixth Chakra
The sixth chakra, namely the third eye chakra, is located between the two eyebrows; that gives the lips and the eyes their first shrinkage, distorting jaws and generating all the eye vision problems.
Source: www.thirdeyehealth.com

CLINICAL SCIENCES: Human Reliability Analysis of Cataract Surgery
Objective  To evaluate the use of the Human Reliability Analysis of Cataract Surgery tool to identify the frequency and pattern of technical errors observed during phacoemulsification cataract extraction by surgeons with varying levels of experience. Design  Observational cohort study. Thirty-three consecutive phacoemulsification cataract operations were performed by 33 different ophthalmic surgeons with varying levels of operative experience: group 1, fewer than 50 procedures; group 2, between 50 and 250 procedures; and group 3, more than 250 procedures. Face and content validity were surveyed by a panel of senior cataract surgeons. The tool was applied to the 33 randomized and anonymous videos by 2 independent assessors trained in error identification and correct tool use. Task analysis using 10 well-defined end points and error identification using 10 external error modes were performed for each case. The main outcome measures were number of errors performed per task, nature of performed errors (executional or procedural), and surgical experience of operating surgeon. Results  Analysis of 330 constituent steps of 33 operations identified 228 errors, of which 151 (66.2%) were executional and 77 (33.8%) were procedural. The overall highest error probability was associated with sculpting, followed by fragmentation of the nucleus; this was most evident in group 1. Surgeons in group 3 proportionally performed more errors during removal of soft lens matter than those in group 1 or 2. Surgical experience had a significant effect on the number of errors, with a statistically significant difference among the 3 groups (P < .001). Conclusions  The Human Reliability Analysis of Cataract Surgery tool is useful for identifying where technical errors occur during phacoemulsification cataract surgery. The study findings, including the high executional error rate, could be used to enhance and structure resident surgical training and future assessment tools. Face, content, and construct validity of the tool were demonstrated.
Source: archopht.ama-assn.org

Vision Problems: Eye Disorders of Refractive Error
Unfortunately, almost every single person on earth has one or the other kind of vision problems - certainly after the age of 40 if not before that.
Source: www.thirdeyehealth.com

Eye Body Language: Body Language That Affects The Eye
Eye body language is the body language of the eye. What do I mean by that? I mean the body language that affects the eye. The health of the eye and the beauty of the eye! What’s the connection?
Source: www.thirdeyehealth.com

Amblyopia: The Lazy Eye
Amblyopia or the lazy eye is something mysterious in its nature. Like allergy is to medicine, same way amblyopia is to ophthalmology - both idiopathic in nature. It’s not even correctable by lenses!
Source: www.thirdeyehealth.com