Related Experiment Video
Updated: Jul 20, 2026
Conjunctival Commensal Isolation and Identification in Mice
Published on: May 1, 2021
Effect of Liposomal-Lactoferrin-Based Eye Drops on the Conjunctival Microflora of Patients Undergoing Cataract
Giuseppe Giannaccare1, Sofia Comis2, Virginia Jannuzzi2
1Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy. giuseppe.giannaccare@unicz.it.
Introduction:
Postoperative endophthalmitis is typically caused by the patient's conjunctival bacterial flora. Povidone iodine solution (5%) is used perioperatively to obtain periocular and ocular antisepsis. However, an adjunctive prophylaxis procedure could further help control the conjunctival microbial load. Considering the increase in antibiotic resistance, a progressive shift toward alternative methods would be desirable. Somilux® eye drops (Alfa Intes, lactoferrin-based eye drops) are medical devices containing liposomal lactoferrin (LF). This study evaluates the effects on conjunctival microflora of LF-based eye drops used in the preoperative phase in patients scheduled for cataract surgery.
Methods:
LF-based eye drops or a vehicle solution (water solution) were instilled 4 times a day starting 3 days before cataract surgery. Before the therapy (T0) and at the time of surgery (T1), a conjunctival swab was performed in both eyes and processed to detect microbial growth, microbiological isolation, and species identification. The outcome was the quantification and characterization of the local microbial flora before and after using LF-based or vehicle-based eye drops. Safety of the treatments was also evaluated.
Results:
88 eyes of 44 patients (mean [± SD] age 75 [± 12.6] years) were enrolled. At baseline, 54 conjunctival swabs showed only saprophytic flora, 27 showed only potential pathogenic flora, and seven showed both of them. LF-based eye drops reduced the proportion of potentially pathogenic bacteria (36% at T0 vs. 9% at T1, p = 0.008) compared with the vehicle (41% at T0 vs. 55% at T1, p = 0.302) without altering the physiological ocular microbial composition. No adverse events have been reported.
Conclusion:
Our findings provide a novel contribution to the scientific knowledge on the role of LF in the ophthalmic field, supporting the use of LF-based eye drops as a safe and selective treatment to improve the ocular surface physiological defenses and control the bacterial ocular surface contamination prior to cataract surgery.
Insights
Lactoferrin (LF)-based eye drops effectively reduced potentially pathogenic bacteria on the ocular surface before cataract surgery. This safe, selective treatment enhances natural defenses against bacterial contamination without altering normal flora.
Area of Science:
- Ophthalmology
- Microbiology
- Pharmacology
Background:
- Postoperative endophthalmitis is a serious complication of cataract surgery, often caused by the patient's own bacterial flora.
- Current perioperative antisepsis with povidone-iodine may be enhanced by strategies to reduce conjunctival microbial load.
- Increasing antibiotic resistance necessitates exploring alternative prophylactic methods.
Purpose of the Study:
- To evaluate the efficacy of lactoferrin (LF)-based eye drops in reducing conjunctival bacterial load prior to cataract surgery.
- To assess the impact of LF-based eye drops on the ocular surface microflora composition.
- To determine the safety profile of LF-based eye drops in this preoperative setting.
Main Methods:
- A randomized controlled trial involving patients undergoing cataract surgery.
- Preoperative administration of either LF-based eye drops or a vehicle solution four times daily for three days.
- Conjunctival swabs collected before therapy (T0) and at surgery (T1) for microbial analysis, including growth, isolation, and species identification.
Main Results:
- LF-based eye drops significantly reduced the proportion of potentially pathogenic bacteria from 36% at baseline to 9% at surgery (p=0.008).
- The vehicle group showed an increase in potentially pathogenic bacteria from 41% to 55% (p=0.302).
- LF treatment did not alter the physiological ocular microbial composition and was well-tolerated, with no adverse events reported.
Conclusions:
- LF-based eye drops represent a safe and selective adjunctive treatment for controlling bacterial contamination on the ocular surface before cataract surgery.
- This approach supports the ocular surface's physiological defenses and offers a promising alternative in the face of rising antibiotic resistance.
- The findings contribute novel scientific insights into the role of lactoferrin in ophthalmic care.
