Suture-related corneal infections after clear corneal cataract surgery

Lee, Brian J.; Smith, Scott D.; Jeng, Bennie H.

doi:10.1016/j.jcrs.2008.10.061

Cited by 31 publications

(28 citation statements)

References 17 publications

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“…22 During suture removal, the surgeon may introduce bacteria into the anterior chamber. 28 The India-ink inflow through suture tracks described in this study could explain in more detail how colonization occurs.…”

Section: Discussionmentioning

confidence: 82%

“…1,15,16,21 Suturing the CCI as an alternative method to secure the wound is widely accepted for the prevention of bacterial penetration into the anterior chamber; however, suturing has been associated with epithelial erosions, corneal ulcers, corneal abscesses, and bacterial colonization. [22][23][24][25][26][27][28] To our knowledge, no controlled laboratory study has been performed to assess the usefulness of suturing in preventing bacterial-sized particle ingress into CCIs. The purpose of this study was to determine the effectiveness of placing a single radial 10-0 nylon suture in 2 commonly used CCI configurations to prevent India-ink particle inflow in the presence of sudden changes in IOP in the immediate postoperative period using an ex vivo human model.…”

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confidence: 99%

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Bacterial-sized particle inflow through sutured clear corneal incisions in a laboratory human model

May

Castro-Combs

Kashiwabuchi

et al. 2011

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 82%

mentioning

confidence: 99%

Bacterial-sized particle inflow through sutured clear corneal incisions in a laboratory human model

May

Castro-Combs

Kashiwabuchi

et al. 2011

Journal of Cataract and Refractive Surgery

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“…P. acnes has been recognized as an emerging cause of shoulder infections (2,3) and is among the most common pathogens isolated in shoulder periprosthetic joint infections (PJI) (4,5). P. acnes has also been implicated in other biofilm-related infections (6)(7)(8), such as cardiovascular implantassociated infections (9), spinal osteomyelitis (10,11), and endophthalmitis (12,13).…”

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confidence: 99%

Optimal Length of Cultivation Time for Isolation of Propionibacterium acnes in Suspected Bone and Joint Infections Is More than 7 Days

et al. 2016

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Diagnosis of Propionibacterium acnes bone and joint infection is challenging due to the long cultivation time of up to 14 days. We retrospectively studied whether reducing the cultivation time to 7 days allows accurate diagnosis without losing sensitivity. We identified patients with at least one positive P. acnes sample between 2005 and 2015 and grouped them into "infection" and "no infection." An infection was defined when at least two samples from the same case were positive. Clinical and microbiological data, including time to positivity for different cultivation methods, were recorded. We found 70 cases of proven P. acnes infection with a significant faster median time to positivity of 6 days (range, 2 to 11 days) compared to 9 days in 47 cases with P. acnes identified as a contamination (P < 0.0001). In 15 of 70 (21.4%) patients with an infection, tissue samples were positive after day 7 and in 6 patients (8.6%) after day 10 when a blind subculture of the thioglycolate broth was performed. The highest sensitivity was detected for thioglycolate broth (66.3%) and the best positive predictive values for anaerobic agar plates (96.5%). A prolonged transportation time from the operating theater to the microbiological laboratory did not influence time to positivity of P. acnes growth. By reducing the cultivation time to 7 days, false-negative diagnoses would increase by 21.4%; thus, we recommend that biopsy specimens from bone and joint infections be cultivated to detect P. acnes for 10 days with a blind subculture at the end. P ropionibacterium acnes is a facultative anaerobic Gram-positive rod, abundant on the human skin, and mainly associated with the sebaceous glands of the shoulder and axilla (1). It is most commonly associated with the chronic skin disease acne vulgaris. However, it may also cause bone and joint infections, including implant-associated infections. P. acnes has been recognized as an emerging cause of shoulder infections (2, 3) and is among the most common pathogens isolated in shoulder periprosthetic joint infections (PJI) (4, 5). P. acnes has also been implicated in other biofilm-related infections (6-8), such as cardiovascular implantassociated infections (9), spinal osteomyelitis (10, 11), and endophthalmitis (12, 13).Diagnosis of P. acnes bone and joint infections is challenging since pain is often the only symptom (14, 15). For a long time, P. acnes was underdiagnosed in bone and joint infections due to the short cultivation time routinely used in diagnostic laboratories. In general, biofilm-forming bacteria are known to replicate at a slow rate due to low metabolism (16). Since recent studies recommended a prolonged cultivation time of up to 14 days for bone and joint infections (17, 18), the diagnosis of P. acnes infections has become more frequently documented (19). In view of the high costs of a long incubation period, a recent study suggested that 7 days of incubation should be sufficient for accurately diagnosing orthopedic implant-associated infections (20). In this study, 96.6% ...

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“…In 2009, three cases of clear corneal cataract incision suture-related corneal infection occurring 9 weeks, 22 months, and 33 months after surgery were reported. 5 A corneal ulcer following sutured clear corneal cataract incision caused by M. abscessus is very rare. Although "cracked windshield" and satellite lesions are considered pathognomonic of Mycobacterium keratitis, they are also observed in fungal or Nocardia keratitis.…”

Section: Commentsmentioning

confidence: 99%

Mycobacterium abscessus corneal ulcer following sutured clear corneal cataract incision

et al. 2010

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Suture-related corneal infections after clear corneal cataract surgery

Cited by 31 publications

References 17 publications

Bacterial-sized particle inflow through sutured clear corneal incisions in a laboratory human model

Bacterial-sized particle inflow through sutured clear corneal incisions in a laboratory human model

Optimal Length of Cultivation Time for Isolation of Propionibacterium acnes in Suspected Bone and Joint Infections Is More than 7 Days

Mycobacterium abscessus corneal ulcer following sutured clear corneal cataract incision

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