title: Three-day application of topical ofloxacin reduces the contamination rate of microsurgical knives in cataract surgery: a prospective randomized study.
abstract: OBJECTIVE
  To determine the rate of contamination of microsurgical knives during cataract surgery and the benefit of a 3-day versus a 1-hour preoperative application of topical ofloxacin in reducing the contamination rate.
  
  
  METHODS
  Prospective, randomized controlled trial.
  
  
  METHODS
  Seventy-eight eyes of 75 patients were randomly assigned to control (39 eyes) or study groups (39 eyes).
  
  
  METHODS
  All patients from both groups received 0.3% topical ofloxacin 1 hour before surgery, 5% povidone-iodine (PVI) scrub of the periorbital area, and 2 drops of PVI onto the ocular surface preoperatively. The patients in the study group also received ofloxacin 4 times a day for 3 days before surgery.
  
  
  METHODS
  Microsurgical knives were placed in blood culture broth media immediately after the incision had been made. The number of positive cultures and types of bacteria isolated were determined.
  
  
  RESULTS
  Ten of 39 knives (26%) in the control group were found to be positive for bacterial growth compared with only 2 of 39 (5%) in the study group (P = 0.028).
  
  
  CONCLUSIONS
  The initial paracentesis incision frequently results in contamination of the microsurgical knife and may serve as a mechanism for introducing bacteria from the ocular surface into the anterior chamber. The application of topical ofloxacin for 3 days before surgery significantly reduces the contamination rate of the microsurgical knives, compared with a preoperative application of ofloxacin given 1 hour before surgery.
authors.affiliation: Department of Ophthalmology, School of Medicine, Stanford University, Stanford, California 94304, USA.
authors.forename: Herminia Miño
authors.initials: HM
authors.lastname: De Kaspar
authors.forename: Robert T
authors.initials: RT
authors.lastname: Chang
authors.forename: Erin M
authors.initials: EM
authors.lastname: Shriver
authors.forename: Kuldev
authors.initials: K
authors.lastname: Singh
authors.forename: Peter R
authors.initials: PR
authors.lastname: Egbert
authors.forename: Mark S
authors.initials: MS
authors.lastname: Blumenkranz
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Ta
mesh_terms: D000287:Administration, Topical; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology; D004866:Equipment Contamination / Q000517:prevention & control*; D015818:Eye Infections, Bacterial / Q000517:prevention & control*; D006801:Humans; D015242:Ofloxacin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D018918:Phacoemulsification / Q000295:instrumentation*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents; D009883:Ophthalmic Solutions; D015242:Ofloxacin