Assessment of Ophtalmologists' Approach to Medical, Legal and Ethical Problems in Process of Corneal Transplantation

Objective: This study was carried out with the aim of investigating medical, ethical and legal problems experienced in the course of cornea transplantation and developing new recommendations in the light of the data obtained from ophthalmologists. Material and Methods: The study was carried out in the ophthalmology clinics of the hospitals affiliated to the Istanbul Health Management. Using a questionnaire, the researchers attempted to determine the level of awareness of the doctors on the issue of cornea donation. A total of 81 ophthalmologists aged between 24 and 54 years, with an experience ranging from 1 to 27 years participated in the study. Results: According to the results obtained from the questionnaire, the number of corneal transplantations carried out by the ophthalmologists included in the study increased significantly with age and professional experience. Below are the percentages of the ophthalmologists and the number of corneal transplantations that they have carried out: 66.7%-none; 11.1%-between 1 and 20; 8.6%-between 11 and 20; 2.5%-between 21 and 50; 1.11%-51 and more. The vast majority of the participants in all the age groups were opposed to the constitution of a national cornea waiting list. It was observed that, as the ophthalmologists gained experience, they became more likely to be accused of unauthorized cornea transplantation. Conclusion: As a result of this study, new recommendations have been developed in order to increase the number of cornea donations in our country and help ophthalmologists to become more aware of the legal procedures and regulations. Cornea centres in various hospitals should be transformed into regional, independent centers so that more cornea removals can be performed. Besides, corneal transplantation should first aim treating the patient, not a cosmetic surgery

Assessment of Ophtalmologists’ Approach to Medical, Legal and Ethical Problems in Process of Corneal Transplantation

Objective: This study was carried out with the aim of investigating medical, ethical and legal problems experienced in the course of cornea transplantation and developing new recommendations in the light of the data obtained from ophthalmologists. Material and Methods: The study was carried out in the ophthalmology clinics of the hospitals affiliated to the Istanbul Health Management. Using a questionnaire, the researchers attempted to determine the level of awareness of the doctors on the issue of cornea donation. A total of 81 ophthalmologists aged between 24 and 54 years, with an experience ranging from 1 to 27 years participated in the study. Results: According to the results obtained from the questionnaire, the number of corneal transplantations carried out by the ophthalmologists included in the study increased significantly with age and professional experience. Below are the percentages of the ophthalmologists and the number of corneal transplantations that they have carried out: 66.7%-none; 11.1%-between 1 and 20; 8.6%-between 11 and 20; 2.5%-between 21 and 50; 1.11%-51 and more. The vast majority of the participants in all the age groups were opposed to the constitution of a national cornea waiting list. It was observed that, as the ophthalmologists gained experience, they became more likely to be accused of unauthorized cornea transplantation. Conclusion: As a result of this study, new recommendations have been developed in order to increase the number of cornea donations in our country and help ophthalmologists to become more aware of the legal procedures and regulations. Cornea centres in various hospitals should be transformed into regional, independent centers so that more cornea removals can be performed. Besides, corneal transplantation should first aim treating the patient, not a cosmetic surgery

Isolates and antibiotic sensitivity of eighty culture-proven endophthalmitis cases from Istanbul

Purpose: To investigate the spectrum of organisms causing endophthalmitis and their sensitivity to commonly used antimicrobial agents. Methods: Medical records of 80 consecutive patients treated at Beyoglu Eye Hospital for endophthalmitis from January 2001 to April 2006 were reviewed. Specimens were obtained from either the vitreous (93%, 81/87) or anterior chamber (7%, 6/87) during pars plana vitrectomy or vitreous tap, and were inoculated into blood culture bottles. A Kirby-Bauer disk diffusion test was performed to determine antibiotic susceptibility. The outcome measures included isolates identified and antibiotic sensitivity of the specimens. Results: Fifty-six of 87 (64.4%) isolates were Gram-positive organisms, 29 (33.3%) were Gram-negative organisms, and 2 (2.3%) were fungi. The most common organism group identified was coagulase-negative staphylococci in 26.4% (23/87). While vancomycin was active against all Gram-positive isolates tested (100%), ceftazidime had the highest susceptibility rate (100%) for Gram-negative organisms isolated. Conclusions: Although coagulase-negative micrococci predominated in this series, a high isolation rate for Gram-negative organisms was obtained. High susceptibility rates for ofloxacin make it an alternative to ceftazidime and vancomycin in both Gram-negative- and Gram-positive-derived endophthalmitis, respectively. Studies with larger series and additional antibiotics are needed to confirm these findings. Copyright (C) 2008 S. Karger AG, Basel