Bacterial contamination of intraocular and extraocular fluids during extracapsular cataract extraction

Abstract

SummaryFluid aspirated from the anterior chamber and fluid drained from the conjunctival sac during 101 extracapsular cataract operations was examined for bacterial con tamination. Bacteria were grown by enrichment culture from the conjunctival sac of 90 eyes and from the anterior chamber aspirate of 29 eyes. Conjunctival fluid, stained with fluorescein, was demonstrated to flow into the anterior chamber during the aspiration stage of extracapsular cataract extraction and during intraocular lens implantation. It is suggested that this fluid from the conjunctival sac, contaminated with bacteria, routinely enters the anterior chamber during extracapsular cataract extraction and is the likely source of some cases of post-operative endophthalmitis.

Climatic influence on conjunctival bacteria of patients undergoing cataract surgery

“…1 Also in the same period, in Scotland, 2 a hospital infection control team reported more acute PE than expected after cataract surgery, according to the normal incidence. 3 Among the many risk factors involved in the PE pathogenesis, [4][5][6][7][8][9][10][11] it is difficult to assess the weight of climatic influence; however, as conjunctival bacteria are the main source of contamination in cataract surgery, 12,13 it is quite logical to expect that the prevalence of conjunctival bacteria determines the prevalence of the infectious PE. Today, the world-wide use of povidona iodine solution as a preoperative prophylaxis in cataract extraction 14 could provide homogeneity in the kind of bacteria that produce PE all over the world, which was impossible to detect when a great number of different prophylactic techniques were used.…”

Influence of age on conjunctival bacteria of patients undergoing cataract surgery

“…[8][9][10][11][12][13][14][15] For these reasons we study the preoperative conjunctival bacteria of patients undergoing cataract surgery at different stages of age. These bacteria are the main source of contamination of intraocular surgery, 16,17 and it is possible that sometimes bacteria produce inflammation that could be treated without developing infectious postsurgical endophthalmitis; but it could damage ocular tissues as well.…”

Contaminação bacteriana da câmara anterior pós-facoemulsificação com implante de lente intra-ocular de polimetilmetacrilato ou silicone

“…No grupo A, com lente de silicone, incisão de 3,0 mm, observou-se o crescimento de Staphylococcus epidermidis em uma amostra (2,5%), no meio de tioglicolato ( Tabela 5) (6)(7)17) . Os patógenos mais comumente encontrados na endoftalmite são coincidentes com a flora habitual da pálpebra e cílios (5) .…”

“…Os líquidos de infusão têm sido objeto de investigação constante; há muitos relatos de contaminação anterior à cirurgia (6) . Há muita controvérsia em relação ao uso de antibiótico tais como vancomicina na prevenção da contaminação bacteriana da câmara anterior (9,21) .…”

“…A contaminação dos fluidos usados na cirurgia (6) , a força de adesão bacContaminação bacteriana da câmara anterior pós-facoemulsificação com implante de lente intra-ocular de polimetilmetacrilato ou silicone teriana ao material que compõe a lente intra-ocular (7) e a cirurgia sem sutura (8) são, dentre outros, fatores que podem determinar o momento da contaminação da câmara anterior. Várias medidas, como o uso de antibioticoterapia prévia e posterior à cirurgia, a instilação de anti-séptico tópico e outras condutas per operató-rias são usadas na prevenção da endoftalmite (9) .…”