• Ocular injury requiring hospitalisation in the south east of Ireland: 2001-2007.

      Saeed, Ayman; Khan, Irfan; Dunne, Orla; Stack, Jim; Beatty, Stephen; Waterford Regional Hospital, Waterford, Ireland. aymantalat@gmail.com (2012-02-01)
      AIM: To investigate whether recent socio-demographic changes and recent health and safety measures have impacted on the trends of ocular trauma in the South East of Ireland. METHODS: We retrospectively reviewed all cases of ocular trauma admitted to our department between October 2001 and September 2007, and the following data were retrieved: demographic details; mechanism of injury and nature of injury. RESULTS: During the study period, 517 patients were admitted with ocular trauma. Work-related and home-related activities were the commonest causes of admission, and accounted for 160 (31.8%) and 145 (28.4%) cases, respectively. In 2006/2007, and following the influx of migrant workers from the 10 new EU accession states (EUAS), the incidence of hospitalised ocular injuries per 100,000 was 89 in persons from the EUAS versus 18 in those of Irish origin, P < or = 0.0001. After adding the offence of not wearing a seat belt to the traffic penalty point system in Ireland, the proportion of road traffic accident (RTA)-related ocular injuries dropped significantly from 6.7% to 2.4%, P=0.03. CONCLUSION: The inclusion of the offence of not wearing a seat belt in the traffic penalty point system may have contributed to the significantly lower proportion of hospitalised ocular injuries attributable to RTAs. Also, the demographic profile of patients admitted because of ocular trauma has changed over the last 6 years, reflected in an increasing proportion of these injuries in persons from the EUAS. These data will inform healthcare providers, and those involved in developing health and safety guidelines for the workplace.
    • Risk factors, microbiological findings, and clinical outcomes in cases of microbial keratitis admitted to a tertiary referral center in ireland.

      Saeed, Ayman; D'Arcy, Fiona; Stack, Jim; Collum, Louis M; Power, William; Beatty, Stephen; Waterford Regional Hospital, Waterford, Ireland. aymantalat@gmail.com (2012-02-01)
      AIM: To identify the risk factors for, and to report the microbiological findings and clinical outcomes of, severe microbial keratitis (MK). METHODS: This was a retrospective study of all cases of presumed MK admitted to a tertiary referral center over a 2-year period (September 2001 to August 2003). Data recorded included demographic data, details relating to possible risk factors, results of microbiological studies, clinical findings at presentation, and clinical and visual outcomes. RESULTS: Ninety patients were admitted with a diagnosis of presumed MK during the study period. The mean age of patients was 45 +/- 32 years, and the male to female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1; 1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%), gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%). Visual acuity improved significantly after treatment [mean best-corrected visual acuity (+/-standard deviation) at presentation: 0.76 (+/-0.11); mean best-corrected visual acuity at last follow-up: 0.24 (+/-0.07); P < 0.001]. Secondary surgical procedures were required in 18 (20%) cases, and these included punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%), tarsorrhaphy (9; 9.9%), Botulinum toxin-induced ptosis (1; 1.1%), penetrating keratoplasty (3; 3.3%), and evisceration (2; 2.2%). CONCLUSIONS: Contact lens wear remains a significant risk factor for severe MK. MK remains a threat to vision and to the eye, but the majority of cases respond to prompt and appropriate antimicrobial therapy.
    • Uncorrected visual acuity in the immediate postoperative period following uncomplicated cataract surgery: bimanual microincision cataract surgery versus standard coaxial phacoemulsification.

      Saeed, Ayman; O'Connor, Jeremy; Cunnife, Geraldine; Stack, Jim; Mullhern, Mark G; Beatty, Stephen; Waterford Regional Hospital, Waterford, Ireland. aymantalat@gmail.com (2012-02-01)
      AIM: We compared bimanual microincision cataract surgery (MICS) and standard coaxial phacoemulsification (CAP) in terms of uncorrected visual acuity (UCVA) recorded 1 h and 2 weeks postoperatively. METHODS: This was a prospective, nonrandomised comparative study. All MICS procedures were performed by one surgeon (MGM), and all CAP procedures were performed by another surgeon (SB). Eyes with visually consequential ocular morbidity were excluded. The primary outcome measure was UCVA recorded 1 h postoperatively. RESULTS: One hundred eyes underwent MICS and CAP (50 eyes in each group). The treatment groups did not differ significantly in terms of preoperative mean best corrected visual acuity (6/24 +/- 4.3 lines and 6/20 +/- 4.4 lines in the MICS and the CAP groups, respectively; P = 0.65). Also, there was no significant difference in terms of postoperative UCVA at 1 h or at 2 weeks (mean +/- standard deviation UCVA 1 h postoperatively: MICS: 6/36 +/- 5.7 lines; CAP: 6/30 +/- 4.7 lines; P = 0.80; UCVA 2 weeks postoperatively: MICS: 6/10 +/- 1.9 lines; CAP: 6/10 +/- 2.2 lines; P = 0.90). However, nine eyes (18%) and one eye (2%) achieved a UCVA of C6/12 at 1 h following MICS and CAP, respectively, and this difference was statistically significant (P = 0.02). CONCLUSION: Mean UCVA at 1 h and at 2 weeks following cataract surgery was not significantly different between eyes undergoing MICS and CAP. However, a greater proportion of patients achieved a UCVA of C6/12 following MICS when compared with CAP.