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Experimental bacterial endophthalmitis following extracapsular lens extraction
1University of Nebraska, College of Medicine, Department of Ophthalmology, Omaha 68105.
Experimental Eye Research
|November 1, 1989
Summary
Extracapsular cataract extraction does not increase bacterial endophthalmitis risk if the posterior lens capsule remains intact. However, incising this capsule allows even small numbers of bacteria to cause intraocular infections.
Area of Science:
- Ophthalmology
- Microbiology
- Surgical Innovation
Background:
- Extracapsular cataract extraction (ECCE) involves instrumentation and irrigation, potentially introducing bacteria.
- The intact lens acts as a barrier against intraocular infections.
- Lens proteins released during surgery might influence bacterial growth.
Purpose of the Study:
- To investigate if ECCE increases susceptibility to bacterial endophthalmitis.
- To determine if the posterior lens capsule protects against infection spread to the vitreous.
Main Methods:
- Rabbit eyes were used to assess bacterial endophthalmitis development after ECCE.
- Staphylococcus aureus (approx. 1000 CFU) was introduced into anterior chambers.
- The effect of posterior lens capsule integrity on infection rates was examined.
Main Results:
- ECCE did not increase infection rates when the posterior capsule was intact.
- Infection occurred in less than half of normal and ECCE eyes with intact posterior capsules.
- Infecting eyes with an incised posterior capsule tripled infection rates.
- As few as 14 CFU could cause infection if the posterior capsule was incised.
Conclusions:
- Intact posterior lens capsule is crucial in preventing bacterial endophthalmitis post-ECCE.
- Posterior capsule disruption significantly lowers the infectious dose required for intraocular infection.
- Lens material released into the aqueous humor has minimal impact on bacterial growth in this model.