الفهرس 
Sterile endophthalmitisOnly 14 pages are availabe for public view
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Abstract
Endophthalmitis is an uncommon but potentially devastating adverse event following ocular surgery or trauma or as a consequence of systemic infection.
There are new trends in management of infective endophthalmitis:
1) New trends for management of postoperative endophthalmitis including the following :
Laser Flare Photometry used for management of peudophakic chronic endophthalmitis:
Laser flare photometry is a reliable noninvasive method to quantify aqueous proteins that gives precise information on the level of anterior chamber inflammation. The reproducibility and sensitivity of this instrument have been shown in several studies and settings during the past decade.
Detection of flare changes with laser flare photometry could contribute to the early diagnosis and suitable treatment of chronic pseudophakic endophthalmitis.
Recombinant tissue plasminogen activator (r-TPA)in fibrin dissolution due to postoperative endophthalmitis
Treatment of endophthalmitis with steroids should be done cautiously and with the knowledge that it takes extensive time to resolve the fibrinous membranes and that the treatment may still be unsuccessful.
Because r-TPA activity is specific for its substance plasminogen and is greatly enhanced in the presence of fibrin, intraocular injection of r-TPA has been reported to be both effective and safe in the treatment of fibrin-related complications of ocular inflammation.
Subconjunctival delivery of antibiotics in controlled release system
Subconjunctival delivery of drugs in controlled release system, testing the feasibility of a biodegradable trans scleral drug delivery system as a more comprehensive anti-infective prophylaxis approach for cataract surgery.
New antimicrobial drugs
Intravitreal Ampicillin Sodium for Antibiotic-Resistant Endophthalmitis: Streptococcus uberis
The use of 5mg/0.1mL of intravitreal ampicillin sodium was based on two previous reports in which the intravitreal administration proved to be safe. Those reports were based on unpublished data from G. A. Peyman in which he established that the ampicillin sodium could be safely administered intraocularly up to a dose of 10mg/0.1mL.
In a reported case, the eye was anatomically salvaged with this treatment regimen, although without visual recovery.
The newer generation fluroquinolones (Moxifloxacin and gatifloxacin):
During the past 10 years, there have been several studies indicating that fluoroquinolone antibiotics achieve significant concentrations in the vitreous after oral administration ;fourth generation fluoroquinolones may represent a major advance in the management of posterior segment infection.
Combined Meropenem and Linezolid as a Systemic Treatment for Postoperative Endophthalmitis; newer generations of systemic antibiotics with an improved antibacterial spectrum are available ;both antibiotics penetrate well through the blood retina barrier.
Evaluation of Pseudomonas aeruginosa staphylolysin (LasA protease) in the treatment of methicillin-resistant Staphylococcus aureus endophthalmitis in a rat model
These enzymes are endopeptidases specific to Gly-Gly bonds that hydrolyze the penta-glycine bridge required for peptidoglycan stabilization in the cell wall of staphylococci. They offer a novel antibacterial tool for the treatment of S. Aureus endophthalmitis.
New surgical treatment of post operative endophthalmitis:
Pars plana vitrectomy and silicone oil tamponade for acute endophthalmitis treatment
Since the early nineties, vitreoretinal surgeons have used silicone oil in some cases of endophthalmitis with extensive retinal damage as intraocular tamponade in order to prevent retinal detachment.
Lens capsular bag irrigation for low-grade endophthalmitis:
Results suggest that irrigation of the capsular bag with an antibiotics-enriched solution as a first surgical step may be a minimally invasive additional tool in the surgical armamentarium to treat bacterial post interventional low-grade endophthalmitis. It may avoid removal of the intraocular lens and thus avoid the need for visual rehabilitation of the aphakic eye, and may also avoid the surgical risks of more complex procedures.
New surgical treatment of posttramatic endophthalmitis:
Endoscopic Vitrectomy for Severe Posttraumatic Endophthamitis with Visualization Constraints.
Endoscopic vitrectomy for severe traumatic endophthalmitis is not only feasible and effective but also has the greatest degree of decrease in damaging eyeball integrity. Hence it is fa¬vorable to the restoration of ocular function and shape.
Update on surgical strategies of bleb-associated endophthalmitis:
Influence of the Endophthalmitis Vitrectomy Study Group.
Use of 25-gauge vitrectomy in bleb-associated endophthalmitis.
Use of systemic antibiotics an issue revisited.
2) New trends in treatment of fungal endophthalmitis either endogenous or exogenous:
Voriconazole: which can be administrated intravitreally intracamerally and systemically.
Caspofungin.
Liposomal amphotricin B which can be administrated intravitreally associated with Pars plana Vitrectomy.
Comparison of antifungal efficacies of moxifloxacin, liposomal amphotericin B, and combination treatment in experimental Candida albicans endophthalmitis in rabbits: it was found that moxifloxacin strongly augments the efficacy of liposomal Amp-B against C. albicans in vitro although it has no in vitro antifungal activity when used alone.