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W T Driebe

Publications and source records attributed to W T Driebe.

28 records · Page 2Linked to original sources
PubMed1989

The treatment of postoperative endophthalmitis. Results of differing approaches to treatment.

The authors treated 26 patients with postoperative endophthalmitis over a 4-year period, between 1983 and 1986. Nineteen patients were culture-positive and seven were culture-negative. All patients received intravitreal antibiotics as part of their treatment regimen. Culture-negative patients generally responded well to a single intravitreal antibiotic injection. Five of seven (71.4%) culture-positive patients who were treated with a single intravitreal antibiotic injection and no vitrectomy suffered either a recurrence of their infection or did not respond to treatment. Four of five patients who received a vitrectomy in addition to a single intravitreal antibiotic injection were cured of their infections; the one patient who received repeated intravitreal antibiotic injections alone and all six patients who received repeated intravitreal antibiotic injections in combination with vitrectomy were cured of their infections. Although the intravitreal injection of antibiotics provides an extremely high initial level of antibiotics inside the eye, a single intravitreal antibiotic injection may only partially treat bacterial endophthalmitis. In culture-negative cases, a single intravitreal injection of antibiotics appears to be sufficient treatment. In culture-positive cases, a higher cure rate is achieved with an aggressive approach which includes the use of repeated intravitreal antibiotic injections and/or vitrectomy.

Aged↗
PubMed1989

Resident extracapsular cataract surgery: results and a comparison of automated and manual techniques.

We retrospectively evaluated 414 faculty-supervised extracapsular cataract extractions performed by ten second and third-year residents. In 94% of the cases without preexisting eye disease 20/40 or better vision was achieved. The most frequent postoperative complication, occurring in 17% of the cases, was a transient rise in intraocular pressure. Late postoperative wound dehiscence occurred in seven cases (1.7%), often associated with chronic obstructive pulmonary disease or trauma. There was no statistically significant difference in visual outcome or in the rates of the most frequent complications in the 260 automated as opposed to the 121 manual cortical removal cases. In particular, there was no difference in the rates of vitreous loss, although posterior capsule tears tended to occur more often in the manual group (P = 0.084).

Aged↗
PubMed1988

Acanthamoeba keratitis. Potential role for topical clotrimazole in combination chemotherapy.

Clotrimazole is an antifungal agent that has been shown to have excellent in vitro activity against most strains of Acanthamoeba. We encountered four patients who developed Acanthamoeba keratitis while wearing contact lenses that had been stored in homemade saline. Their medical treatment regimens included the use of topical 1% clotrimazole. In two patients in whom conventional therapy failed, clotrimazole was successful in controlling recurrent infection following penetrating keratoplasty. Two other patients were treated with clotrimazole as well as propamidine isethionate and neomycin sulfate-polymyxin B sulfate-gramicidin from the outset, and had an excellent response to medical therapy. In those patients who found the commercially available cream uncomfortable, a 1% clotrimazole suspension formulated in artificial tears was used and found to be well tolerated.

Acanthamoeba↗
PubMed1987

Serious corneal complications of glaucoma filtering surgery with postoperative 5-fluorouracil.

We studied four patients who, having received postoperative 5-fluorouracil after glaucoma filtering operations, developed serious corneal complications. All four patients had preexisting corneal abnormalities including keratoconjunctivitis sicca, exposure keratopathy, and bullous keratopathy. All of the patients developed epithelial defects in the postoperative period. The complications included bacterial corneal ulceration (two patients), sterile corneal ulceration and corneal perforation (one patient), and a keratinized corneal plaque with underlying sterile stromal infiltrate (one patient). The use of 5-fluorouracil, which is an antimetabolite with considerable corneal epithelial toxicity, after glaucoma filtering surgery frequently causes corneal epithelial defects that may lead to secondary complications. Patients receiving this drug should have their corneal status closely monitored. In patients with corneal epithelial disease, 5-fluorouracil should be used with caution.

Aged↗
PubMed1987

Posttraumatic Bacillus cereus endophthalmitis.

We encountered a patient who developed Bacillus cereus endophthalmitis following trauma. Early therapy, which included intravitreal clindamycin phosphate and gentamicin sulfate, resulted in a visual acuity of 20/60. A five-year retrospective review of all cases of endophthalmitis following trauma reported at our institution revealed Bacillus as the infecting organism in six (46%) of 13 culture-positive cases. The high frequency of virulent Bacillus infections in the setting of trauma necessitates the use of antibiotics that are active against this organism in posttraumatic endophthalmitis. The combination of clindamycin and gentamicin can be effective therapy in Bacillus species infections if used early in the course of the disease.

Accidents, Occupational↗
PubMed1987

Contact lenses.

Explore the source record for details and available documents.

Astigmatism↗
PubMed1987

Acanthamoeba keratitis. A growing problem in soft and hard contact lens wearers.

Eleven contact lens-wearing patients presented with Acanthamoeba keratitis. Eight cases were culture- and/or stain-positive for Acanthamoeba and three were presumed to have Acanthamoeba keratitis based on history and clinical findings. Six wore daily wear soft contact lenses, two wore extended-wear soft contact lenses, one wore a polymethylmethacrylate hard contact lens, one wore a gas-permeable hard contact lens, and one wore a Saturn lens (combined hard and soft lens). Four patients used distilled water and salt tablet saline, three used tap water and salt tablet saline, two used tap water rinse, two used well water rinse or storage, and one used intravenous (IV) saline. It is apparent that all contact lens wearers are at some risk for Acanthamoeba keratitis developing if proper contact lens care is not maintained. Of great concern is the inability of most current chemical sterilization methods to kill the organism if the lens becomes contaminated. Heat disinfection will kill Acanthamoeba trophozoites and cysts but the lens must not be placed into contaminated solutions afterward. Prevention is very important because medical and surgical treatment failures are frequent. Eye care practitioners who fit contact lenses are advised to use heat disinfection for low-water content stock soft contact lenses, and to use hydrogen peroxide without a catalyst for a minimum of 6 hours for all other stock lens fitting sets, to specifically inquire about contact lens care habits used by their patients, and to discourage the use of homemade saline solutions.

Acanthamoeba↗
PubMed1986

Pseudophakic endophthalmitis. Diagnosis and management.

Eighty-three cases of endophthalmitis occurring in eyes with intraocular lenses are presented. A problem with the cataract section was felt to contribute to development of the endophthalmitis in 22% of patients. Seventy-five percent of eyes were culture positive with a microbiologic spectrum similar to other reported series without lens implants. Staphylococcus epidermidis was the most common organism accounting for 38% of the isolates. Therapeutic vitrectomy was performed in 46 cases (55%), generally in those eyes with the most severe inflammation. Intraocular lenses were removed in 23 cases (28%), usually to facilitate vitrectomy. Only 1 of 57 eyes with bacterial endophthalmitis could not be sterilized while the intraocular lens was retained. Visual acuity of 20/400 or better was achieved in 63% of culture positive cases, in 78% of eyes infected with S. epidermidis, and in 94% of culture negative eyes.

Aged↗
PubMedDate not supplied

Disposable soft contact lenses.

Disposable soft lenses are now available for extended wear. These lenses were designed to provide a more acceptable margin of safety than conventional extended wear soft lenses. Disposable lenses, which are intended to be discarded after 1-2 weeks of continuous wearing time, do offer a number of theoretical advantages. The short wearing schedule minimizes deposit formation which has been implicated in the development of giant papillary conjunctivitis and infectious keratitis. Lens disinfection systems, which are expensive and time consuming, and may become contaminated, are rarely needed if the manufacturer's guidelines are followed. Careful longterm follow-up of disposable soft lens patients will be needed to establish actual patient compliance and the safety of these lenses.

Contact Lenses, Hydrophilic↗