Increase in microbial contamination risk with compression of the lid margin in eyes having cataract surgery

Purpose: To assess the bacterial contamination risk in cataract surgery associated with mechanical compression of the lid margin immediately after sterilization of the ocular surface.

Setting: Department of Cataract, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Design: Prospective randomized controlled double-masked trial.

Methods: Patients with age-related cataract were randomly assigned to 1 of 2 groups. In Group A (153 eyes), the lid margin was compressed and scrubbed for 360 degrees 5 times with a dry sterile cotton-tipped applicator immediately after ocular sterilization and before povidone-iodine irrigation of the conjunctival sac. Group B (153 eyes) had identical sterilization but no lid scrubbing. Samples from the lid margin, liquid in the collecting bag, and aqueous humor were collected for bacterial culture. Primary outcome measures included the rate of positive bacterial culture for the above samples. The species of bacteria isolated were recorded.

Results: Group A and Group B each comprised 153 eyes. The positive rate of lid margin cultures was 54.24%. The positive rate of cultures for liquid in the collecting bag was significantly higher in Group A (23.53%) than in Group B (9.80%) (P=.001).The bacterial species cultured from the collecting bag in Group B were the same as those from the lid margin in Group A. The positive culture rate of aqueous humor in both groups was 0%.

Conclusion: Mechanical compression of the lid margin immediately before and during cataract surgery increased the risk for bacterial contamination of the surgical field, perhaps due to secretions from the lid margin glands.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Phacoemulsification combined with posterior capsulorhexis and anterior vitrectomy in the management of malignant glaucoma in phakic eyes

Purpose: To describe sequential phacoemulsification-intraocular lens (IOL) implantation-posterior capsulorhexis-anterior vitrectomy in the management of phakic malignant glaucoma. Methods: Twenty consecutive patients (25 eyes) with phakic malignant glaucoma were enrolled at the Zhongshan Ophthalmic Center, Sun Yat-sen University. All patients underwent phacoemulsification, IOL implantation and posterior capsulorhexis together with anterior vitrectomy via a clear corneal paracentesis. Visual acuity, intraocular pressure (IOP), anterior chamber depth (ACD), surgical complications and medications required after the surgery were recorded. Results: After surgery, the mean LogMAR visual acuity and ACD increased significantly (visual acuity from -1.56 ± 1.17 to -0.54 ± 0.81, p < 0.001; ACD from 0.367 ± 0.397 mm to 2.390 ± 0.575 mm, p < 0.001), and mean IOP decreased significantly (from 39.6 ± 10.6 mm Hg to 14.5 ± 4.1 mmHg, p < 0.001). No serious perioperative complications occurred, and only five eyes required topical glaucoma medications after surgery. Conclusion: Combined phacoemulsification-IOL implantation-posterior capsulorhexis-anterior vitrectomy surgery is a safe and effective method for treating patients with phakic malignant glaucoma. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

Prevalence of corneal astigmatism before cataract surgery in Chinese patients

Purpose: To assess the demographics and distribution of corneal astigmatism before cataract surgery in Chinese patients. Setting: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Clinic-based cross-sectional study. Methods: From July 2009 to May 2011, preoperative bilateral partial coherence interferometry (IOLMaster) was performed in consecutive patients having cataract surgery. Patient demographics and keratometric data were recorded. Results: The mean age of the 2849 patients (4831 eyes) was 70.56 years ± 9.55 (SD); there was a predominance of women patients (64.0%). The mean axial length was 23.58 ± 1.13 mm. The mean corneal astigmatism in this cohort was 1.01 D (range 0.05 to 6.59 D). Corneal astigmatism was between 0.25 D and 1.25 D in 67.7% of eyes, 1.25 D or higher in 27.5% eyes, and less than 0.25 D in 4.8% of eyes. Astigmatism was with the rule in 25.1% of eyes, against the rule (ATR) in 58.2% of eyes, and oblique in 16.7% of eyes. The mean steep keratometry measurement was 44.76 ± 1.56 D. Against-the-rule astigmatism increased significantly with older age. Conclusions: Corneal astigmatism largely fell between 0.25 D and 1.25 D in these predominantly elderly female Chinese patients, and ATR astigmatism increased with age. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2012 ASCRS and ESCRS.

Comparison of anterior ocular biometry between optical low-coherence reflectometry and anterior segment optical coherence tomography in an adult Chinese population.

PURPOSE: To evaluate the agreement between optical low-coherence reflectometry (OLCR) and anterior segment optical coherence tomography (AS-OCT) for biometry of the anterior segment. SETTING: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. DESIGN: Evaluation of diagnostic technology. METHODS: A series of OLCR (Lenstar LS 900) and AS-OCT measurements of the anterior segment were taken for consecutive subjects aged 35 years and older in a population-based study. The differences and correlations between the 2 methods of ocular biometry were assessed. Agreement was calculated as the 95% limits of agreement (LoA). RESULTS: The mean age of the 776 subjects was 55.2 years ± 12.0 (SD); 54.6% were women. The mean central corneal thickness (CCT) was smaller with OLCR than with AS-OCT (537.84 ± 31.46 μm versus 559.39 ± 32.02 μm) as was anterior chamber depth (ACD) (2.60 ± 0.37 mm versus 2.72 ± 0.37 mm) and anterior chamber width (ACW) (11.76 ± 0.47 mm versus 12.04 ± 0.55 mm) (all P<.001). The 95% LoA between the 2 instruments were -44.80 to 1.71 μm for CCT, -0.17 to -0.06 mm for ACD, and -1.28 to 0.72 mm for ACW. CONCLUSION: Optical low-coherence reflectometry and AS-OCT yielded potentially interchangeable ACD measurements, while the CCT and ACW measurements acquired by the 2 devices showed clinically significant differences.

Wavelet phase coherence analysis: Application to a quiet-sun magnetic element

A new application of wavelet analysis is presented that utilizes the inherent phase information residing within the complex Morlet transform. The technique is applied to a weak solar magnetic network region, and the temporal variation of phase difference between TRACE 1700 Angstrom and SOHO/SUMER C II 1037 Angstrom intensities is shown. We present, for the first time in an astrophysical setting, the application of wavelet phase coherence, including a comparison between two methods of testing real wavelet phase coherence against that of noise. The example highlights the advantage of wavelet analysis over more classical techniques, such as Fourier analysis, and the effectiveness of the former to identify wave packets of similar frequencies but with differing phase relations is emphasized. Using cotemporal, ground-based Advanced Stokes Polarimeter measurements, changes in the observed phase differences are shown to result from alterations in the magnetic topology.

Propagating waves and magnetohydrodynamic mode coupling in the quiet-sun network

High-cadence multiwavelength optical observations were taken with the Dunn Solar Telescope at the National Solar Observatory, Sacramento Peak, accompanied by Advanced Stokes Polarimeter vector magnetograms. A total of 11 network bright points (NBPs) have been studied at different atmospheric heights using images taken in wave bands centered on Mg I b(1) - 0.4 Angstrom, Halpha, and Ca II K-3. Wavelet analysis was used to study wave packets and identify traveling magnetohydrodynamic waves. Wave speeds were estimated through the temporal cross-correlation of signals, in selected frequency bands of wavelet power, in each wavelength. Four mode-coupling cases were identified, one in each of four of the NBPs, and the variation of the associated Fourier power with height was studied. Three of the detected mode-coupling, transverse-mode frequencies were observed in the 1.2-1.6 mHz range (mean NBP apparent flux density magnitudes over 99-111 Mx cm(-2)), with the final case showing 2.0-2.2 mHz (with 142 Mx cm(-2)). Following this, longitudinal-mode frequencies were detected in the range 2.6-3.2 mHz for three of our cases, with 3.9-4.1 mHz for the remaining case. After mode coupling, two cases displayed a decrease in longitudinal-mode Fourier power in the higher chromosphere.

Ultraviolet oscillations in the chromosphere of the quiet Sun

Quiet-Sun oscillations in the four Transition Region and Coronal Explorer (TRACE) ultraviolet passbands centered on 1700, 1600, 1216, and 1550 Angstrom are studied using a wavelet-based technique. Both network and internetwork regions show oscillations with a variety of periods and lifetimes in all passbands. The most frequent network oscillation has a period of 283 s, with a lifetime of 2-3 cycles in all passbands. These oscillations are discussed in terms of upwardly propagating magnetohydrodynamic wave models. The most frequent internetwork oscillation has a period of 252 s, again with a lifetime of 2-3 cycles, in all passbands. The tendency for these oscillations to recur in the same position is discussed in terms of "persistent flashers." The network contains greater oscillatory power than the internetwork at periods longer than 300 s in the low chromosphere. This value is shown to decrease to 250 s in the high chromosphere. The internetwork also displays a larger number of short-lifetime, long-period oscillations than the network, especially in the low chromosphere. Both network and internetwork regions contain a small number of nonrecurring long-lifetime oscillations.

Electron densities in the coronae of the Sun and Procyon from extreme-ultraviolet emission line ratios in Fe XI

New R-matrix calculations of electron impact excitation rates for Fe XI are used to determine theoretical emission line ratios applicable to solar and stellar coronal observations. These are subsequently compared to solar spectra of the quiet Sun and an active region made by the Solar EUV Rocket Telescope and Spectrograph (SERTS-95), as well as Skylab observations of two flares. Line blending is identified, and electron densities of 10(9.3), 10(9.7), greater than or equal to 10(10.8), and greater than or equal to 10(11.3) cm(-3) are found for the quiet Sun, active region, and the two flares, respectively. Observations of the F5 IV-V star Procyon, made with the Extreme Ultraviolet Explorer (EUVE) satellite, are compared and contrasted with the solar observations. It is confirmed that Procyon's average coronal conditions are very similar to those seen in the quiet Sun, with N-e = 10(9.4) cm(-3). In addition, although the quiet Sun is the closest solar analog to Procyon, we conclude that Procyon's coronal temperatures are slightly hotter than solar. A filling factor of 25(-12)(+38)% was derived for the corona of Procyon.