This study analyzed the clinical features and molecular characteristics of methicillin-susceptible Staphylococcus aureus (MSSA) ocular infections in Taiwan and compared them between community-associated (CA) and health-care-associated (HA) infections. We collected S. aureus ocular isolates from patients at Chang Gung Memorial Hospital between 2010 and 2017. The infections were classified as CA or HA using epidemiological criteria, and the isolates were molecularly characterized using pulsed-field gel electrophoresis, multilocus sequence typing, and Panton-Valentine leukocidin (PVL) gene detection. Antibiotic susceptibility was evaluated using disk diffusion and an E test. A total of 104 MSSA ocular isolates were identified; 46 (44.2%) were CA-MSSA and 58 (55.8%) were HA-MSSA. Compared with HA-MSSA strains, CA-MSSA strains caused a significantly higher rate of keratitis, but a lower rate of conjunctivitis. We identified 14 pulsotypes. ST 7/pulsotype BA was frequently identified in both CA-MSSA (28.3%) and HA-MSSA (37.9%) cases. PVL genes were identified in seven isolates (6.7%). Both CA-MSSA and HA-MSSA isolates were highly susceptible to vancomycin, teicoplanin, tigecycline, sulfamethoxazole–trimethoprim, and fluoroquinolones. The most common ocular manifestations were keratitis and conjunctivitis for CA-MSSA and HA-MSSA, respectively. The MSSA ocular isolates had diverse molecular characteristics; no specific genotype differentiated CA-MSSA from HA-MSSA. Both strains exhibited similar antibiotic susceptibility.

Purpose: To analyze visual quality and contrast sensitivity in patients after intraocular lens (IOL) implantation with sutured scleral fixation. Setting: Chang Gung Memorial Hospital, Taoyuan, Taiwan. Design: Retrospective observational study. Methods: Data on the refractive outcome, visual acuity, and subjective visual symptoms in patients with scleral-fixated or in-bag IOL implantation were collected from September 2019 to March 2020. We also investigated patients’ postoperative higher-order aberrations (HOAs) and dysphotopsia using a wavefront aberrometer and glaretester, respectively. The following values were compared: corrected distance visual acuity, spherical equivalent, root mean square values for aberrations, and contrast sensitivity. Results: A total of 23 eyes implanted with scleral-fixated IOL and 74 eyes with in-bag IOL were studied. The mean postoperative spherical equivalent and logarithm of the minimum angle of resolution after scleral fixation were −1.09 ± 3.32 D and 0.20 ± 0.17, respectively. The ocular HOAs were higher in the scleral-fixation group than in the in-bag group (p = 0.001). Contrast sensitivity was negatively associated with age, and it was similar between the two groups after controlling for the age effect. Conclusions: Ocular HOAs and refractive errors were higher in the scleral-fixation group than in the in-bag group. However, no significant difference was noted in contrast sensitivity between advanced scleral fixation and in-bag IOL implantation.

: To analyze the incidence, risk factors, and microbial profiles of infectious keratitis after different types of keratoplasty, we conducted a retrospective multi-institutional study using the Chang Gung Research Database in Taiwan and included keratoplasty cases between January 2001 and December 2022. Procedural codes were used to identify keratoplasty cases, and infectious keratitis was confirmed by positive culture results. Outcomes included the incidence of infectious keratitis after penetrating keratoplasty, anterior lamellar keratoplasty, and endothelial keratoplasty as well as associated pathogens and risk factors. Logistic regression analysis was performed to identify significant risk factors, including age, surgical technique, and systemic and ocular conditions. In total, 297 patients with infectious keratitis after keratoplasty were identified. The percentage of infectious keratitis within 1 year after keratoplasty increased from 7.7% in 2001–2011 to 14.0% in 2012–2022, with the highest rates observed after anterior lamellar keratoplasty followed by penetrating keratoplasty and endothelial keratoplasty. Older age, ocular surface diseases, and anterior lamellar keratoplasty were significant risk factors. Gram-positive bacteria, particularly Staphylococcus species, were the most commonly isolated pathogens, whereas Pseudomonas aeruginosa was the predominant Gram-negative bacterium. Fusarium and Candida species were the leading fungal pathogens, and viral pathogens, including cytomegalovirus and Epstein–Barr virus, were identified in a small subset. In conclusion, the incidence of infectious keratitis after keratoplasty has increased over time ( P <0.0001), with anterior lamellar keratoplasty showing the highest proportion of infectious keratitis among the three surgical methods, and recognition of key risk factors may aid clinical decision-making and postoperative care.