1.Suture-related corneal abscess caused by enterococcus casseliflavus following complicated phacoemulsification surgery
Patricia Kaye T. Sy ; Karlo Marco D. Claudio
Philippine Journal of Ophthalmology 2024;49(1):61-65
Objective:
To report a case of a suture-related corneal abscess caused by Enterococcus casseliflavus on a phacoemulsification corneal incision.
Method:
This is a case report.
Results:
An elderly female underwent complicated phacoemulsification surgery on the left eye requiring sutures
to seal the corneal incisions. Suture removal was incomplete at the side port, and a suture abscess developed
after 9 weeks. Cultures revealed heavy growth of Enterococcus casseliflavus which was initially treated with an
empiric broad-spectrum antibiotic (levofloxacin 1.5%) administered via intrastromal and subconjunctival
injections, followed by culture-guided topical and oral medications. The corneal infection resolved but
significant corneal thinning led to perforation, requiring a modified Gunderson flap procedure to repair the
defect.
Conclusion
Intrastromal and subconjuctival injection of levofloxacin 1.5% may be a viable empiric treatment
option for Enterococcus casseliflavus suture-related corneal abscess.
Phacoemulsification
2.Prognostic value of a classification and regression tree model in patients with open-globe injuries
Danica T. Esteban ; Karlo Marco D. Claudio ; Cheryl A. Arcinue
Philippine Journal of Ophthalmology 2024;49(1):28-32
Objective:
To evaluate the accuracy of the Classification and Regression Tree (CART) model in
prognosticating visual outcomes of patients with open-globe injuries
Methods:
This was a retrospective, single-center, cohort study of patients with open-globe injuries seen over
a two-year period. Purposive sampling of hospital medical records was done to collect data from both in- and
out-patient cases. The CART algorithm was utilized to determine the predicted visual outcome for each case,
and the accuracy of prognostication was measured by computing for sensitivity, specificity, positive predictive
value, and negative predictive value. The area under the receiver operating characteristic curve was used to
check its discriminatory capability.
Results:
A total of 65 eyes (65 patients) with the following diagnoses based on the Birmingham Eye Trauma
Terminology (BETT) classification were included: penetrating eye injury (n=58), globe rupture (n=2), and intraocular foreign body (n=5). Majority were male patients (81.5%) in the 17-39 year age group (40%). The
sensitivity and specificity of CART were 100% (95% CI 93.6 to 100%) and 77.8% (95% CI 40 to 97.2%),
respectively, with an overall accuracy of 96.9% (95% CI 89.3 to 99.6%). Area under the curve (AUC) was
statistically significant at 0.89 (95% CI 0.79 to 0.95), indicating that the CART model can discriminate vision
survival versus no vision.
Conclusion
The CART model demonstrated high accuracy in prognosticating visual outcomes after an openglobe injury in the local setting. It may be used as a helpful tool to guide treatment decisions in open-globe injuries.
Eye Injuries, Penetrating