Intraocular bacterial contamination during sutureless, small incision, single-port phacoemulsification

PURPOSE: To evaluate the incidence of anterior chamber bacterial contamination during no-stitch, 1-handed, small incision phacoemulsification. SETTING: Little Company of Mary Hospital, Evergreen Park, Illinois, USA. METHODS: This study comprised 53 eyes of 46 patients. Topical gentamicin sulfate was administered 1 hour preoperatively. After povidone-iodine cleansing solution and povidone-iodine paint (5% and 10%) were applied, the eyes were draped in a sterile manner. Aqueous fluid was aspirated upon entering the anterior chamber and at the end of surgery; the specimens were cultured for up to 14 days. All eyes had no-stitch, 1-handed, small incision phacoemulsification with implantation of a foldable acrylic posterior chamber intraocular lens through a 3.5 mm scleral tunnel incision. RESULTS: Three specimens (5.7%) aspirated on entry into the anterior chamber were positive for microorganisms. Of the cultures obtained at the end of surgery, 4 (7.5%) were positive for microorganisms. All posterior lens capsules were intact. The following organisms were cultured at the end of phacoemulsification: alpha-streptococci, micrococci, saprophytic mold, alpha-viridans streptococci, coagulase-negative Staphylococcus species, and anaerobic positive cocci. No eye developed endophthalmitis. CONCLUSIONS: The incidence of anterior chamber bacterial contamination was low. Bacterial contamination of the anterior chamber occurred at the beginning and toward the end of phacoemulsification. Staphylococcus species was the most common organism in the beginning, while Streptococcus species was the most common at the end. Saprophytic mold was present only at the end. No eye developed endophthalmitis.