JAMA ophthalmology
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The Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) study is the only ongoing nationwide antibiotic resistance surveillance program specific to ocular pathogens. ⋯ Methicillin resistance was prevalent among staphylococcal isolates from ocular infections, with many strains demonstrating multidrug resistance. These findings are consistent with resistance trends reported for nonocular staphylococcal isolates. Overall ocular resistance did not increase during the 5-year study period. Continued surveillance of ocular isolates provides critical information to guide selection of topical antibacterials used for empirical management of ocular infections.
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The timing and indications for repair of orbital floor fractures have been controversial. Current practice dictates that fractures involving more than 50% of the orbital floor should be repaired. Early management is initiated in such situations to prevent long-term sequelae of enophthalmos and diplopia. Because fracture size as measured by computed tomography (CT) is one of the criteria to determine the need for surgical repair, there is a need to know the reliability of this parameter. ⋯ Although the literature has long held that a floor fracture seen radiographically to involve 50% of the orbital floor has a high likelihood of enophthalmia and should be repaired, this study shows how variable CT measurements of orbital floor fractures can be in a clinical setting, even in trained hands. We question the dependence on such a criterion and reemphasize the importance of making surgical decisions based on clinical findings rather than radiological interpretations.