EyeWorld Korea June 2019 Issue

34 EWAP JUNE 2019 A t the 34th Con- gress of the Asia-Pacific Academy of Ophthalmology in Bangkok, Thailand, Prashant Garg, MD , LV Prasad Eye Institute, Hyderabad, India, and Donald T.H. Tan, FRCS , Singapore National Eye Cen- tre, Singapore, provided their perspectives on the Asia Cornea Society Infectious Keratitis Study (ACSIKS) study, organisms that cause ophthalmic infections, and how the data may have an impact on antibiotic choices in both India and the Asia-Pacific region. Corneal infections are one of the most prevalent causes of corneal opacity and loss of vision in many developing countries. The burden is much higher in the New Perspectives on Microbial Organisms and Ophthalmic Infections Using ACSIKS Data Supplement to EyeWorld Asia-Pacific Summer 2019 APACRS Asia-Pacific region. There are several reasons for this: the first is that a large population resides in the Asia-Pacific region. The sec- ond is related to socioeconom- ics, with many countries in the Asia-Pacific region having large numbers of residents from a lower or middle economic background, with agriculture or manual labor the predominant occupation. In these nations, corneal foreign body or abrasion is the most im- portant risk factor for corneal in- fections. In contrast to developed countries, and especially in more urbanized populations, contact lens wear becomes a much more prominent risk factor for corneal infections. In 2013, the Asia Cornea Society launched a multinational study in 8 countries and 27 sites to determine the risk factors for corneal infection, the epidemiol- ogy of causative organisms, an- timicrobial susceptibility profiles, and treatment outcomes, with the overarching objective of finding ways to reduce the burden of blindness from this disease. The study sites were asked to enroll every case of keratitis using a preapproved study protocol. The cases were investigated using standardized microbiology proto- cols including comprehensive an- tibiotic susceptibility testing. The study duration was set at over a year and a half, with a target of enrolling 3,000 to 4,000 cases. The study ultimately had more than 6,500 cases of keratitis. The above clinical study was considered Phase One of ACSIKS. In Phase Two, which is currently nearing completion, all cultured bacterial and fungal organisms have been subcultured and stored in central ACSIKS re- positories in Singapore and India. Reidentification and categoriza- tion as well as more comprehen- sive susceptibility testing will be performed. In the meantime, other countries, such as Indonesia and Vietnam, also have approached the Asia Cornea Society request- ing to participate in ACSIKS. Dr. Tan believes there would be great benefit to have a secondary study including additional pop- ulation samples. “The beauty of ACSIKS is that we can compare data among countries because the methodology is the same,” he said. Finally, with the revalidated bacterial and fungal isolates in our central repository, additional focused microbiological sub-stud- ies can be performed as part of Phase Three of ACSIKS, and these may include genotyping and mutational analysis of resis- The news magazine of the Asia-Pacific Association of Cataract & Refractive Surgeons “ The beauty of ACSIKS is that we can compare data among countries because the methodol- ogy is the same. ” Donald T.H. Tan, FRCS SPECIAL REPORT Supple ent to Eye orld sia-Pacific June 2019 Copyright 2019 APACRS. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or publisher, and in no way imply endorsement by EyeWorld, Asia-Pacific or APACRS.