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Anterior chamber aspirate cultures after uncomplicated cataract surgery
J B Dickey1, K D Thompson, W M Jay
1Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153.
Abstract:
We cultured anterior chamber aspirates of 30 patients who had uncomplicated extracapsular cataract extraction or phacoemulsification. The aspirate was obtained at the time of wound closure. Of 30 patients, 13 (43%) had culture-positive anterior chamber aspirates. The total number of organisms recovered was 18, with three patients having multiple organisms identified. The most commonly isolated organisms were coagulase-negative Staphylococcus sp., occurring in eight of 18 isolates (44%). No eyes in our study developed endophthalmitis, even though almost one half had viable organisms growing from the anterior chamber aspirates. Inoculum sizes were extremely small (10 to 20 colony-forming units/ml). This study suggests that in humans, the anterior chamber is capable of clearing a low inoculum of bacteria after cataract surgery without the development of endophthalmitis.
Insights
Even with bacteria present after cataract surgery, the eye can clear infections. This study found no endophthalmitis in patients with positive anterior chamber cultures.
Area of Science:
- Ophthalmology
- Microbiology
- Surgical Infections
Background:
- Cataract surgery, including extracapsular cataract extraction and phacoemulsification, can lead to anterior chamber contamination.
- The risk of post-operative endophthalmitis is a significant concern in ophthalmic surgery.
Purpose of the Study:
- To investigate the incidence of bacterial contamination in anterior chamber aspirates following uncomplicated cataract surgery.
- To determine if low-level bacterial presence correlates with the development of endophthalmitis.
Main Methods:
- Anterior chamber aspirates were collected from 30 patients undergoing cataract surgery at wound closure.
- Aspirates were cultured to identify bacterial presence and species.
- Patients were monitored for the development of endophthalmitis.
Main Results:
- 13 out of 30 patients (43%) had culture-positive anterior chamber aspirates.
- Coagulase-negative Staphylococcus sp. was the most common organism isolated (44% of isolates).
- No patients developed endophthalmitis despite positive cultures, with very small inoculum sizes (10-20 CFU/ml).
Conclusions:
- The human anterior chamber demonstrates a capacity to clear low bacterial inoculums post-cataract surgery.
- Minimal bacterial contamination may not invariably lead to endophthalmitis in the absence of significant inoculum.
- Further research into the ocular immune response and bacterial clearance mechanisms is warranted.