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Published on: February 6, 2021
Heparinised intraocular infusion and bacterial contamination in cataract surgery
T D Manners1, D P Turner, P H Galloway
1Department of Ophthalmology, West Norwich Hospital.
Background/Aims:
Heparin in solution reduces bacterial adhesion to intraocular lenses and a lower incidence of postoperative endophthalmitis has been reported with the use of heparin coated lenses. The safety of adding low molecular weight heparin to the infusion fluid during routine cataract surgery was investigated. Any direct antibacterial effect was looked for by culturing anterior chamber fluid samples taken at the completion of surgery.
Methods:
A randomised, double blind, controlled study of 111 patients undergoing routine cataract surgery. Low molecular weight heparin at a concentration of 5 IU/ml was added to the infusion fluid in the trial patients. Samples from the anterior chamber taken at completion of surgery were cultured. Twenty nine samples of sterile infusion fluid were also cultured as further controls.
Results:
No complications were found in either group, and no difference in observed postoperative inflammation in each group. In the heparinised group (n = 55) bacterial contamination was found in 31% of samples, compared with 27% in the no heparin group (n = 56) (no significant difference).
Conclusions:
There appears to be no direct antibacterial effect of heparin, and other possible mechanisms of action are discussed. Heparin avoids many of the drawbacks of traditional antibiotic prophylaxis and may have the potential to be a safe and effective addition to endophthalmitis prevention.
Insights
Adding low molecular weight heparin to intraocular lens surgery infusion fluid did not reduce bacterial contamination. This study found no direct antibacterial effect of heparin in preventing endophthalmitis.
Area of Science:
- Ophthalmology
- Infectious Disease Prevention
- Surgical Innovation
Background:
- Heparin reduces bacterial adhesion to intraocular lenses.
- Heparin-coated lenses are associated with lower endophthalmitis rates.
- Investigating the safety and efficacy of adding heparin to infusion fluid during cataract surgery.
Observation:
- A randomized, double-blind, controlled study involved 111 patients undergoing cataract surgery.
- Low molecular weight heparin (5 IU/ml) was added to the infusion fluid in the trial group.
- Anterior chamber fluid samples were cultured post-surgery; sterile infusion fluid samples served as controls.
Findings:
- No complications or increased postoperative inflammation were observed in the heparin group.
- Bacterial contamination rates were similar: 31% in the heparin group vs. 27% in the control group.
- No statistically significant difference in bacterial contamination was found between groups.
Implications:
- Heparin demonstrated no direct antibacterial effect in this study.
- Alternative mechanisms for heparin's potential role in endophthalmitis prevention are discussed.
- Heparin may offer a safe alternative to traditional antibiotic prophylaxis for endophthalmitis prevention.
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