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Further Studies Needed: A Reply

Linux vs. Windows: You Have a Choice

Another Way to Donate

Further Studies Needed: A Reply

We thank Douglas A. Katsev, MD, for his interest in the study entitled “Topical Prophylaxis With Moxifloxacin Prevents Endophthalmitis in a Rabbit Model”¹ (Letters, June). In response, we would like to clarify a few important points.

The bacterial strain used to inoculate the anterior chambers of all animals was isolated from a patient who presented with endophthalmitis. This was a wild-type Staphylococcus aureus that demonstrated no resistance or elevated MICs to the fluoroquinolones. All animals received the same inoculum, and all in the control group developed endophthalmitis. 

The diagnoses were made by experienced clinicians and based on several ocular signs, including hypopyon. While all control animals demonstrated clinical evidence of infection, anterior chamber cultures were positive in only 50 percent of the animals, and posterior chamber cultures were positive in 30 percent. This discrepancy between clinical exam and culture positivity was also reported in the Endophthalmitis-Vitrectomy Study, which had a culture-positive rate of 70 percent. None of the rabbits that received moxifloxacin drops before and after inoculation developed signs of endophthalmitis, and all cultures were negative in this group.

Also, bacteria can be found postoperatively in the anterior chamber in many cataract cases that do not progress to endophthalmitis. While it is important to reduce surface ocular flora, antibiotics that also penetrate the anterior chamber at therapeutic levels have a theoretical advantage. This does not diminish the benefit of using fast-acting antimicrobials preoperatively.

We agree that it is important to scrutinize animal studies and to make certain that the agents used were actual commercial preparations and not intravenous formulations that may have vastly different pH, etc. In this study, the commercial preparation of moxifloxacin 0.5 percent was used.

Deepinder K. Dhaliwal, MD, and Regis P. Kowalski, MS
Pittsburgh

______________________________
1 Kowalski, R. P. et al. Am J Ophthalmol 2004;138(1):33–37.


Linux vs. Windows: You Have a Choice

I enjoyed reading “Protect Your Practice: Internet Security 101” (Practice Perfect, March) and would like to share my own office computing experience.

I used to use Windows 2000 with a dial-up Internet connection. Unwanted pop-up windows often appeared on my screen and software was installed onto my hard drive without my consent. This was slowing my computer down enough to make it unusable.

As a result, I purchased the Mandrake version of Linux for $70 and installed it onto my computer. It only took about an hour, and I have not experienced any problems with it.

Mandrake, as well as the other versions of Linux, provide excellent security without the need for additional antivirus and/or antispyware programs. They also come with a large collection of software, are reasonably priced and easy to install.

Now that I have switched to Linux, I would never go back to using Windows. But it is possible to run Windows programs on a Linux computer using a program called “Win4Lin,” which is available for purchase online.

You do have a choice when it comes to software. Linux provides you with an operating system that is secure, easy-to-use and reasonably priced.

 

Michael C. Ford, MD
Sioux Falls, S.D.


Another Way to Donate

I appreciated Richard P. Mills, MD, MPH, addressing the important topic of donating to the Surgical Scope Fund in “The Surgical Scope Fund: Have You Stepped Up to the Plate?” (Opinion, February). In addition to mailing donations into the Academy, there is a more convenient option —donating directly through the Academy's Web site at www.aao.org/ssf.


Marcus M. Marcet, MD

Madison, Wis.

 

 

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