VIDEO: Vancomycin 'rarely' associated with HORV

WAIKOLOA, Hawaii — At Hawaiian Eye, David F. Chang, MD, discussed the association found between vancomycin and HORV reported in 12 cataract surgery cases, and the steps anterior segment surgeons and retinal specialists are taking together to investigate the causes.

Retinal specialists have collected a dozen cases of hemorrhagic occlusive retinal vasculitis (HORV), according to Chang.

“There is definitely an association with intracameral vancomycin,” he states in the video. “It is probably the most devastating complication we can have in cataract surgery.

At this point the cause of the occlusive vasculitis is not known, Chang said it is most likely “a highly unusual immunologic sensitivity.”

In his presentation earlier Tuesday, Chang said that HORV is “devastating but may be extremely rare.” In the discussion that followed, Eric D. Donnenfeld, MD, said of the 12 known cases, all were associated with either a bolus of vancomycin or an issue with the dilution. He said that is the reason he now puts the vancomycin in the bag.

Chang said the American Society of Cataract and Refractive Surgeons’ (ASCRS) clinical committee is working with a task force from the American Society of Retinal Specialists (ASRS), and a registry has been started on the ASRS website ASRS.org, to collect data on any new cases to help find the causes. – by David W. Mullin and Joan-Marie Stiglich, ELS

Reference:

Chang D. Current Practice Patterns: ASCRS Survey Results. Presented at: Hawaiian Eye 2016 meeting; Jan. 18, 2016; Waikoloa, Hawaii.

Disclosures: Chang reports he is a financial interest with Abbott Medical Optics, Allergan, Calhoun Vision, Icon Bioscience, LensAR, Mynosis, PowerVision; Transcend Medical, Donnenfeld reports he is a consultant for AcuFocus, Allergan, Alcon, Abbott Medical Optics, Aquesys, Bausch + Lomb, Beaver-Visitec, CRST, Elenza, Glaukos, Icon Biosciences, Kala Pharmaceuticals, Katerna, LacriPen, Mati Pharmaceuticals, Merck, Mimetogen, Novabay, Novaliq, OcuHub, Odyssey Medical, Omega Ophthalmics, Omeros, Pfizer Ophthalmics, PRN Pharmaceutical, RPS, Shire, Strathspey Crown, Tearlab, TearScience, The Laser Centers, TrueVision, Versant Venture, WaveTec and Carl Zeiss Meditec.