Spectrum and susceptibilities of microbiologic isolates in the Endophthalmitis Vitrectomy Study.

Role of External Bacterial Flora in the Pathogenesis of Acute Postoperative Endophthalmitis

Endophthalmitis after cataract surgery: a nationwide prospective study evaluating incidence in relation to incision type and location.

Phacoemulsification and modern cataract surgery.

• We previously found that half-strength (5%) povidone-iodine solution significantly reduced the bacterial flora of the conjunctiva. To compare the antibacterial effect of a topical combination antibiotic (Neosporin ophthalmic solution) given three times daily for three days preoperatively with that of half-strength povidone-iodine solution given as part of the preoperative preparation, conjunctival cultures were studied from 35 patients undergoing ocular surgery. When used individually, the antibiotic and povidone-iodine solutions caused a similar and substantial decrease in the number of colonies and species of bacteria cultured. When both drugs were used together, the decrease was even more striking, making 83% of the conjunctivae sterile. To minimize bacterial flora before ocular surgery, we recommend that a broad-spectrum topical antibiotic be given for three days preoperatively and that half-strength povidone-iodine solution be used as part of the preoperative preparation.

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=OPHTH&articleId=635696&pdfFileName=archopht_103_9_039.pdf

Chemical Preparation of the Eye in Ophthalmic Surgery: IV. Comparison of Povidone-Iodine on the Conjunctiva With a Prophylactic Antibiotic

One hundred sterile intraocular lenses were placed on the external eye of 50 patients during cataract surgery. Half of the specimens were cultured for bacteria, the other half were examined under the light microscope after fixing and staining. A bacterial contamination rate of 26% was recorded. This is significantly higher than that found in conjunctival swabs (6%) or irrigation specimens (8%) taken at the same time, and higher than that recorded in a group of control lenses (15.2%) exposed to operating theatre air alone. We propose that intraocular lenses contaminated with viable bacteria may be implanted into the eye and thereby account for some cases of postoperative uveitis in the pseudophakic eye.

https://bjo.bmj.com/content/bjophthalmol/68/8/520.full.pdf

R J Marsh

Papers

Bacterial contamination of intraocular lens surgery.