Prospective evaluation of external ocularmicrobial growth and aqueous humor contamination during cataract surgery |
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| Institution: | 1. Helsinki University Eye Hospital Haartmaninkatu, Finland;2. Department of Bacteriology and Immunology, The Haartman Institute, University of Helsinki, Finland;1. Department of Computer Engineering, Erciyes University, 38030 Kayseri, Turkey;2. Genome and Stem Cell Center (GenKök), Erciyes University, 38030 Kayseri, Turkey;1. Genome and Stem Cell Center (GenKök), Erciyes University, 38030 Kayseri, Turkey;2. Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Erciyes University, 38030 Kayseri, Turkey;1. Beyoglu Eye Training and Research Hospital, Bereketzade Cami Sok., 34421 Beyoglu, Istanbul, Turkey;2. Academie Eye Hospital, Denizli, Turkey;1. Allergy Unit of the 3rd Paediatric Department, Aristotle University of Thessaloniki, Greece;2. Department of Paediatrics, Imperial College London, London, UK;3. Department of Medical Statistics, Democritus University of Thrace, Greece;4. Department of Paediatrics, Democritus University of Thrace, Greece;5. Hippokration Hospital, Aristotle University of Thessaloniki, Greece;6. Department of Otorhinolaryngology, Democritus University of Thrace, Greece |
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| Abstract: | Purpose:To analyze the route of aqueous humor contamination leading to thedevelopment of postoperative endophthalmitis.Setting:Department of Ophthalmology, University of Helsinki, Finland.Methods:Forty-nine eyes of 49 patients (31 having phacoemulsification and 18 extracapsularcataract extraction ECCE]) participated in the study. Four bacterial cultures were taken: preoperative conjunctival swab, lid margin culture, intraoperative lacrimal lake sample, and immediate postoperative anterior chamber fluid sample.Results:Preoperative lid margin cultures were positive in 59.2% of eyes, conjunctival cultures in 69.4%, and lacrimal lake cultures in 24.9%. Four aqueous humor samples (8.2%) showed bacterial growth in the anterior chamber aspirate: 3 in the phacoemulsification and 1 in the ECCE group. The bacteria isolated in this study, Staphylococcus epidermidis and Propionibacterium acnes (2 positive isolates each) were sensitive to the preoperative topical antibiotics used. No aqueous humor sample or any from other locations showed gram-negative microbe growth. The most frequently recovered microbes in all samples collected from the 3 other sources were S epidermidis and other coagulase-negative staphylococcus species, followed by P acnes and other propionibacterium species, Staphylococcus aureus, and diptheroids.Conclusion:The ocular surface significantly contributed fo the transmission ofmicrobes into the eye during cataract surgery. These microbes could not be eradicated by topical preoperative antibiotics. However, no patient developed postoperative endophthalmitis. Natural defense mechanisms appear to fend off a minor inoculum with these microbes of relatively low pathogenicity. |
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