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Postoperative contamination after using vancomycin and gentamicin during phacoemulsification

J F Ferro1, M de-Pablos, M J Logroño

  • 1Department of Ophthalmology, Hospital of Txagorritxu, Vitoria, Spain. jferro@redestb.es

Archives of Ophthalmology (Chicago, Ill. : 1960)
|February 1, 1997
PubMed
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Adding vancomycin and gentamicin to irrigating solutions during phacoemulsification did not significantly reduce positive postoperative intraocular cultures. While the placebo group had more positive cultures, the difference lacked statistical significance, suggesting further research is needed.

Area of Science:

  • Ophthalmology
  • Infectious Disease
  • Surgical Innovation

Background:

  • Postoperative endophthalmitis remains a concern after cataract surgery.
  • Intraocular antibiotics are explored to prevent infection.
  • Phacoemulsification with lens implantation is a common surgical procedure.

Purpose of the Study:

  • To determine if adding vancomycin and gentamicin to irrigating solutions during phacoemulsification reduces positive postoperative intraocular cultures.
  • To assess the efficacy of intraocular antibiotics in preventing bacterial contamination during cataract surgery.

Main Methods:

  • A two-part, double-masked, placebo-controlled, randomized clinical trial was conducted.
  • The primary study involved 120 eyes undergoing uncomplicated phacoemulsification with lens implantation.

Related Experiment Videos

  • Patients received either irrigating fluid with vancomycin and gentamicin or placebo, followed by anterior chamber aspiration and culturing.

    • Main Results:

    • Intraocular antibiotics had a half-life of less than 2 hours.
    • Positive cultures were found in 5.0% of the antibiotic-treated group versus 12.0% in the placebo group.
    • The observed difference in positive cultures did not reach statistical significance (P =.18).

    Conclusions:

    • The addition of vancomycin and gentamicin to irrigating solutions during phacoemulsification did not significantly decrease positive postoperative intraocular cultures.
    • The study did not provide statistically significant evidence to support routine use of these antibiotics in irrigating solutions.
    • Further research is recommended to explore the clinical implications and optimal use of antibiotics in ophthalmic surgical irrigation.