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Bacterial culture after three sterilization methods for cataract surgery
Keiji Inagaki1, Tatsuo Yamaguchi, Sachiko Ohde
1Department of Ophthalmology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan. inakei@luke.or.jp
Japanese Journal of Ophthalmology
|October 20, 2012
Summary
Eye washing without eyelid eversion effectively reduces conjunctival bacteria before cataract surgery. This method also leads to milder anterior chamber inflammation post-surgery compared to techniques involving eyelid eversion.
Area of Science:
- Ophthalmology
- Microbiology
- Surgical Infection Prevention
Background:
- Cataract surgery requires sterile conditions to prevent postoperative complications.
- Bacterial contamination of the conjunctiva is a risk factor for endophthalmitis.
- Effective preoperative ocular surface disinfection is crucial for patient safety.
Purpose of the Study:
- To compare the efficacy of three different eye-washing methods in reducing conjunctival bacterial load before cataract surgery.
- To evaluate the impact of these methods on postoperative anterior chamber inflammation.
Main Methods:
- A prospective randomized study involving 75 eyes undergoing cataract surgery.
- Three groups received different eye-washing protocols: 5% povidone-iodine (Group A), 0.02% chlorhexidine with eyelid eversion (Group B), and 0.02% chlorhexidine without eyelid eversion (Group C).
- Conjunctival swabs and aqueous humor samples were collected pre- and post-operatively. Postoperative inflammation was assessed using slit-lamp microscopy.
Main Results:
- Groups A and C showed a significant reduction in conjunctival bacteria post-washing (p=0.008 and p=0.016, respectively).
- Group B did not demonstrate a significant decrease in bacterial load (p=0.125).
- Group C exhibited significantly milder anterior chamber inflammation one day after surgery compared to Group B (p=0.032).
Conclusions:
- Eye-washing techniques without eyelid eversion are more effective in reducing preoperative conjunctival bacteria.
- These methods also appear superior in minimizing postoperative anterior chamber inflammation.
- Non-everting chlorhexidine eye washes offer a promising approach for enhancing surgical site sterility in cataract procedures.
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