Department News
Prevention of Endophthalmitis
September 2007
Dr. Lisa Nijm, a senior ophthalmology resident at the University of Illinois Eye and Ear Infirmary, has been awarded three grants in the past year for her project entitled “Utilizing a Hydrophilic Intraocular Lens as a Drug Delivery System for the Prevention of Endophthalmitis.” She received two consecutive grants from the Illinois Society for the Prevention of Blindness for novel research in the prevention of endophthalmitis. In addition, she was awarded one of five student stipends by Midwest Eye-Banks to promote young investigators with promising research into the causes and treatment of blinding eye diseases. |
Endophthalmitis is a potential complication of cataract surgery affecting 0.13% of those who undergo cataract surgery. Although rare, this complication is potentially devastating and can result in vision loss, and in very rare instances may even require removal of the eye.
However, to date efforts to prevent endophthalmitis have not been completely successful. Currently there exists no treatment that can provide sufficient penetration at high enough concentrations to deliver optimal levels of antibiotic to the eye. Moreover, previous research has indicated that prolonged exposure to antibiotics during or at the completion of the surgery is required to prevent this serious, though rare, complication.
Given the ongoing need to find a method of prophylaxis, Dr. Nijm and professors, Dr. Elmer Tu, Dr. Lawrence Ulanski and Richard Fiscella, at the University of Illinois studied the utility of a hydrophilic intraocular lens as a drug delivery system to prevent endophthalmitis.
Based on preliminary research conducted by Dr. Nijm as a medical student at Southern Illinois University School of Medicine, the Staar Collamer Intraocular lens was chosen because it has the requisite properties to successfully deliver antibiotics at high enough concentrations to prevent endophthalmitis. Staar Collamer Intraocular lens contains a unique copolymer of collagen and hydroxymethylmethacrylate with a water content of approximately 40% and excellent biocompatibility.
The research team implanted antibiotic soaked Staar Collamer Intraocular lenses into rabbit eyes, and subsequently measured the level of antibiotic present in samples taken at timed intervals. Even at 24-hours, the concentration of antibiotic (moxifloxacin) was very high; at all timepoints, the antibiotic release was high enough to exceed the minimum inhibitory concentration of most of the common bacteria which cause endophthalmitis.
Although further research is still in progress, Dr. Nijm concludes that that this research may assist in the development of valuable prevention tools in deterring this potentially devastating complication of cataract surgery.
Dr. Lisa Nijm is a graduate of the dual M.D./J.D. program at Southern Illinois University School of Medicine and School of Law . She will complete her residency training at the University of Illinois Eye and Ear Infirmary in June 2008 and plans to pursue a fellowship in cornea. In the future, Dr. Nijm hopes to practice as a corneal specialist advocating for her patients and the profession while pursuing pertinent research for the prevention of blindness.
by Cindy Veldhuis, Staff Writer