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Other advances in chorio-retinal surgery. A comparative study of sponge infections
Abstract:
During a period of seven years out of 900 explant operations done in New York 31 sponges had to be removed. In Bonn during the same period a comparable 27 explants out of 1000 operations had to be removed. Clinical infection occurred as early as one week and as late as seven years after the operation. The infection of the sponge manifested as: fistula, granuloma or a subconjunctival haemorrhagic mass. 2/3 of the infections were due to staphylococcus epidermis which acts as a pathogen in the presence of a foreign body. Bonn's requirement of a sterile conjunctiva preoperatively and the use of prophylactic antibiotics postoperatively did not significantly reduce the rate of infection.
Insights
Ocular sponges can cause late-onset infections like fistulas or granulomas, often due to staphylococcus epidermis. Even sterile techniques and antibiotics did not significantly reduce these foreign body infections.
Area of Science:
- Ophthalmology
- Biomaterials Science
Background:
- Ocular sponges are used in explant operations.
- Foreign body reactions and infections can occur after implantation.
Purpose of the Study:
- To investigate the incidence and characteristics of ocular sponge infections following explant operations.
- To evaluate the effectiveness of sterile techniques and prophylactic antibiotics in preventing these infections.
Main Methods:
- Retrospective analysis of explant operations in New York and Bonn over seven years.
- Documentation of sponge removal, infection types, and causative agents.
Main Results:
- 31 out of 900 explants (New York) and 27 out of 1000 explants (Bonn) required sponge removal due to infection.
- Infections occurred between one week and seven years post-operation, presenting as fistulas, granulomas, or hemorrhagic masses.
- Staphylococcus epidermis was identified in two-thirds of infections, acting as a pathogen in the presence of a foreign body.
- Bonn's protocol of sterile conjunctiva and prophylactic antibiotics did not significantly lower infection rates.
Conclusions:
- Ocular sponge infections are a significant complication following explant surgery.
- Staphylococcus epidermis is a common pathogen in these infections.
- Current preventative measures, including sterile techniques and antibiotics, show limited efficacy in reducing infection rates.
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