Following bolus intracameral injection at the end of cataract surgery the concentration of vancomycin in the anterior chamber vastly exceeds its MIC for at least 24 hours but is predicted to fall below the MIC after 33 hours.

Sequential surgery appears to offer no significant advantages over the triple procedure in terms of refractive predictability or variability. There was a slight trend toward more patients achieving 6/12 or better vision in the sequential group.

Purpose To test the agreement of intraocular pressure (IOP) measurements made with Luneau SA applanators and Goldmann applanator. Materials and Methods A single-blind crossover trial. IOPs were measured in both eyes of subjects with both applanators. Type of applanator was alternated to eliminate systematic bias. Multiple observers were used. Observers were blind to the scale while performing measurements but not to the type of applanator used. The appearance of the meniscus was assessed semiquantitatively. All measurements were combined and presented in a Bland-Altman plot. Results A total of 140 eyes of 79 subjects were tested by seven observers. The range of measurements was 6-45 mmHg (mean 17.8 mmHg) for the Goldmann applanator. On average, the Luneau SA applanator (range of measurements 4-36 mmHg) gave a measurement of 2.35 mmHg less than the Goldmann standard. The standard deviation of these differences was 2.13 mmHg, giving an upper 95% confidence limit of 6.53 mmHg and a lower 95% confidence limit of À1.83 mmHg. The measurements agreed in only 24 out of 140 instances. In 28 eyes, the disposable tonometer end point was difficult to assess owing to excessively thick rings. Linear extrapolation suggests an increase in difference with increasing IOP. Conclusion The inter-head inaccuracy, tendency to underestimate IOP, and lack of systematic inaccuracy make a corrective algorithm impossible to formulate. The range of variation between the Luneau SA disposable applanator and the Goldmann standard is sufficiently large to influence clinical management decisions. We speculate that one explanation is the interaction of the tonometer with the tear film, making end point determination difficult. Further research is being undertaken.

Large-diameter BCLs may be a useful treatment option in the management of refractory vernal ulcers.

No abstract