Phacoemulsificator and sterile drapes contamination during cataract surgery: a microbiological study

Area of Science:

• Ophthalmology
• Microbiology
• Surgical Infections

Background:

• Postoperative endophthalmitis remains a significant concern following cataract surgery.
• Intraoperative microbial contamination of irrigating fluids is a potential source of infection.
• Prophylactic measures, including topical antibiotics and povidone-iodine, are standard practice.

Purpose of the Study:

• To assess microbial contamination in irrigating fluids during phacoemulsification.
• To evaluate the efficacy of topical povidone-iodine and antibiotic prophylaxis in preventing contamination.
• To identify potential sources of microbial contamination in the surgical setup.

Main Methods:

• A prospective study of 119 patients undergoing cataract surgery.
• Administration of levofloxacin and topical 5% povidone-iodine prophylaxis.
• Sterile collection of irrigating fluid samples from drainage bags (DBL) and peristaltic pump cassettes (PCL).
• Microbiological analysis for aerobic and anaerobic bacteria and fungi.

Main Results:

• Microbial growth detected in 31.5% of patients (44.5% DBL vs. 18.5% PCL).
• 111 microbial strains identified: 74% Gram-positive bacteria, 18% fungi, 8% Gram-negative bacteria.
• Fungi predominantly isolated from PCL; staphylococcal isolates higher in DBL.
• No correlation between microbial isolation and risk factors; no postsurgical infections observed.

Conclusions:

• Intraoperative fluid analysis can reveal infection sources.
• Antibiotic prophylaxis and povidone-iodine significantly reduce the risk of endophthalmitis.
• Current prophylactic regimens appear effective in preventing clinical infections despite fluid contamination.