Efficacy of antibacterial preparations instillation in suppression of conjunctival sac microflora before operations on the eyeball

Session Details

Session Title: Free Paper Session 5: Anterior/Posterior Segment Surgery

Session Date/Time: Thursday 07/09/2017 | 11:00-12:30

Paper Time: 12:00

Venue: Room 117

First Author: : V.Kazaikin RUSSIA

Co Author(s): :    O. Shilovskikh   T. Novoselova   V. Ponomarev   A. Kleymenov   V. Kazantsev   O. Markina              

Abstract Details

Purpose:

To estimate the efficacy of antibacterial preparations (ABP) instillation in suppression of conjunctival sac microflora before operations on the eyeball.

Setting:

IRTC Eye Microsurgery Ekaterinburg centre, Ekaterinburg, Russia

Methods:

The study included 33 patients (66 eyes) undergoing cataract surgery with IOL implantation on one eye (study group), fellow eyes of all the patients made control group. Study group eyes received levofloxacin 0.5% instillations as preoperative treatment; control group eyes did not receive ABP instillations. The study included laboratory and clinical parts. Laboratory investigation. Just before the operation, content of the lower conjunctival fornix was taken from both eyes under sterile conditions. Within 60 minutes the material was delivered in a thermo-container to the microbiology laboratory. The material was seeded on nutrient media with identification of grown microbial colonies in Vitek – 2 compact automatic analyzer (Biomerieux, France). Clinical investigation included analysis of performed operations and ophthalmological status after the operation. First of all, presence or absence of inflammatory reactions was estimated. All the 33 operations were uneventful. Operation field was treated with povidone-iodine 7.5% solution; 2% colloidal silver solution was instilled in the conjunctival sac. At the end of operation, ceftazidime was injected under the conjunctiva, 0.5% epibulbar levofloxacin was applied. After the operation all the operated eyes received 0.5% levofloxacin instillations 5 times daily for 1 week.

Results:

Laboratory investigation. In the study group, microbial growth was achieved in 21 case (63.6%): Staphylococcus epidermidis – 3(14.2%), Enterococcus faecium – 6(28.5%), Streptococcus pneumoniae – 1(4.8%), Pseudomonas aeruginosa – 1(4.8%), Enterococcus faecalis – 1(4.8%), associated Staphylococcus hominis, Leuconostoc mesenteroides and Haemophilus influenza – 1(4.8%), Staphylococcus haemolyticus – 2(9.5%), Staphylococcus hominis – 3(14.2%), Acinetobacter baumannii – 1(4.8%), Streptococcus mitis – 1(4.8%), Staphylococcus lugdunensis – 1(4.8%). In the control group, microbial growth was achieved in 20 cases (60.6 %): Staphylococcus aureus – 1 (5%), Staphylococcus epidermidis – 6 (30%), Staphylococcus hominis – 3 (15%), Enterococcus faecium – 1 (5%), associated Pseudomonas aeruginosa, Staphylococcus haemolyticus – 1 (5%), associated Pseudomonas aeruginosa, Enterococcus faecalis and Burkholderia cepacia – 1 (5%), associated Staphylococcus warneri and Streptococcus mitis – 1 (5%), Acinetobacter baumannii – 2 (10%), Pasteurella pneumotropica – 1 (5%), Staphylococcus warneri – 1 (5%), Alloiococcus otitidis – 1(5%), Kocuria rosea – 1(5%). Thus, there was no significant difference between study and control groups. Clinical investigation. During the entire follow-up period (7 to 10 months, mean 8.45±0.19) there were no inflammatory reactions in the operated eyes.

Conclusions:

Single ABP instillation before operations on the eyeball do not provide complete microflora elimination in the conjunctival sac. The crucial role in prophylaxis of intraocular infection in the postoperative period belongs to preoperative treatment of the operation field as well as to intra- and postoperative prophylactic measures.

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