Sub-Tenon infiltration with 3 mL of bupivacaine 0.50% offers excellent postoperative analgesia for about 6 h and is an excellent alternative to classical drugs. Furthermore, it is highly reliable and safe.

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Purpose Fluorescein is commonly used in ophthalmology to confirm a diagnostic of corneal ulceration. In case of infectious keratitis, microbiological investigations are necessary involving anesthetic eye drops administration and corneal sampling. An antibacterial activity has already been described associated with anesthetic eye drops yielding therefore a risk of false negative result. However fluorescein influence has never been studied. This study was aimed at evaluating antibacterial in vitro activity for fluorescein and for most common anesthetic eye drops. Methods The most frequently isolated germs in case of infectious keratitis (S. epidermidis, S. aureus, P. aeruginosa, S. pneumoniae, M. lacunata, M. catarrhalis and C. macginleyi) have been tested. The determination of the minimum inhibitory concentrations (MICs) for the different eye drops (0.5% fluorescein, 0.4% oxybuprocaine and 1% tetracaine) was achieved by microdilution in liquid medium. Results Fluorescein did not exhibit antibacterial activity for most germs (MICs > 2500 mg/L) except for Moraxella (M. catarrhalis and M. lacunata), for which the MICs observed were 1250 mg/L and 625 mg/L respectively and corresponding to a dilution of 1/4 and 1/8 of the commercial solution. Conclusion At the usual concentration of 0.5% (5 g/L), fluorescein does exhibit antibacterial activity for Moraxella bacteria. Therefore, it is essential to properly wash the eye with sterile physiological serum before sampling in order to eliminate fluorescein and local anesthetic.