CLINICAL NEWS: MEDICAL AND PRODUCT UPDATES

PREVENTING CATARACTS
The Hormone Connection

A study involving 1,239 women between the ages of 65 and 84 conducted at the Wilmer Eye Institute in Baltimore, Md., found that postmenopausal women taking hormone replacement therapy (HRT) have a reduced risk of lens opacities.

Compared to women who had never used HRT, current users had half the risk of nuclear opacities. Recent use of HRT lowered the risk to 0.4. Use of HRT in the distant past was protective, but only if the subject had never been pregnant. (Previous and current use of HRT also lowered the risk of posterior subcapsular opacity.) Lifestyle factors such as sunlight exposure, alcohol consumption, smoking and steroid use were taken into account, as were height, weight and body mass index.

SURGICAL COMPLICATIONS
Ciprofloxacin Resistance Increasing

Investigators at the Wills Eye Hospital in Philadelphia have found that endophthalmitis bacteria are be-coming increasingly resistant to ciprofloxacin and other antibiotics. (Many M.D.s rely on ciprofloxacin as a first-string treatment for endophthalmitis.)

Researchers reviewed 248 cases of endophthalmitis that occurred at the hospital between 1989 and 2000, comparing resistance reported between 1989 and 1994 with reports between 1995 and 2000. Both periods produced the same number of cases, but during the earlier years, 23% of the cases showed resistance to ciprofloxacin; in the later years, 37.8% showed resistance. In 1998, more than 50% of patients with endophthalmitis were resistant to ciprofloxacin.

Data on other antibiotics showed the same trend:

• trimethoprim-sulmethoxazole re-sistance increased from 25.7% to 28.8%
• resistance to cefazolin increased from 23% to 31.1%
• resistance to bacitracin increased from 7.4% to 12.3%.

No cases of resistance to vancomycin were reported, however.