Anterior chamber irrigation with an ozonated solution as prophylaxis against infectious endophthalmitis.
OBJECTIVE
To assess the validity of anterior chamber irrigation with an ozonated solution as prophylaxis against endophthalmitis.


METHODS
Department of Ophthalmology, Nippon Medical School, Tokyo, Japan.


METHODS
Viability of human corneal endothelium in culture was assessed by the WST-8 assay, lactate dehydrogenase (LDH) release assay, and trypan blue exclusion assay after exposure to a 4 to 40 parts per million (ppm) solution for 10 to 60 seconds. The in vivo effect was observed 1 week after irrigation of a 4 ppm solution in the rabbit anterior chamber by trypan blue exclusion assay. Bactericidal efficacy of the anterior chamber irrigation with the 4 ppm solution was examined by bacterial colony count of the aqueous humor following methicillin-resistant Staphylococcus aureus (MRSA) contaminated intraocular lens implantation in the porcine eye.


RESULTS
The WST-8 assay revealed no significant reduction of viability with 10-second exposure to a 4 ppm solution. Lactate dehydrogenase release and trypan blue exclusion assays similarly demonstrated little damage after 60-second exposure to a 4 ppm solution. In the rabbit cornea 1 week after treatment, damage caused by 30-second exposure to a 4 ppm solution was not significant. The MRSA colony count documented almost complete bactericidal action with 5-second exposure to the 4 ppm solution when no ophthalmic viscosurgical device existed in the anterior chamber.


CONCLUSIONS
Limited damage to the corneal endothelium after 10-second exposure and potent bactericidal action with 5-second exposure suggests the validity of anterior chamber irrigation with a 4 ppm ozonated solution as prophylaxis against endophthalmitis.
Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan. tash@nms.ac.jp
Hiroshi
H
Takahashi
Chiaki
C
Fujimoto
Hironori
H
Matsui
Tsutomu
T
Igarashi
Toshihiko
T
Shiwa
Kunitoshi
K
Ohara
Tohru
T
Sugita
D000818:Animals; D000867:Anterior Chamber / Q000187:drug effects* / Q000382:microbiology; D018929:Cell Culture Techniques; D002470:Cell Survival; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D004728:Endothelium, Corneal / Q000187:drug effects / Q000201:enzymology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D019654:Lens Implantation, Intraocular; D008297:Male; D016106:Methicillin Resistance; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D010083:Oxidants, Photochemical / Q000627:therapeutic use*; D010126:Ozone / Q000627:therapeutic use*; D018918:Phacoemulsification; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D007507:Therapeutic Irrigation / Q000379:methods; D014343:Trypan Blue / Q000378:metabolism
D009883:Ophthalmic Solutions; D010083:Oxidants, Photochemical; D010126:Ozone; D007770:L-Lactate Dehydrogenase; D014343:Trypan Blue