Bacterial flora--A potential source of endophthalmitis after cataract surgery.
OBJECTIVE
To study bacteria from eye lids and conjunctival sac of patients undergoing cataract surgery before and after the application of antiseptics.


METHODS
Patients undergoing elective cataract extraction in one university hospital were randomly enrolled. Cultures for bacteria and candida were done by swabbing the eye lids before and after cleaning with 4% chlorhexidine gluconate. Subsequently 10% povidone iodine was applied on eye lids and conjunctival sacs. Cultures of specimens from eye lids and conjunctival sac were taken after the application of 10% povidone iodine and at the end of the operation.


RESULTS
Fifty-one patients were enrolled. Positive cultures were found in 90.2% and 82.4% before and after cleaning the face with 4% chlorhexidine. After topical application of 10% povidone iodine, only 19.6% had positive cultures from eye lids and conjunctival sac; a significant reduction (p=0.001). At the end of the operation, positive cultures were found from eye lids in 10 patients and from the conjunctival sac in 4 patients. Isolates were skin flora and candida species in 2 patients. None of the patients had endophthalmitis.


CONCLUSIONS
Cleaning eye lids with 4% chlorhexidine followed by applying 10% povidone iodine was effective in decreasing skin flora in cataract surgery. The organisms were not completely eliminated. Postoperative follow-up to detect infectious complications is warranted.
Rongrungruang
Yong
Y
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok.
Tantaterdthum
Jutalai
J
Tuntiwattanapibul
Yuwadee
Y
Sripalakij
Siriporn
S
Danchaivijitr
Somwang
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002387:Cataract Extraction / Q000009:adverse effects*; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003228:Conjunctiva / Q000382:microbiology*; D009877:Endophthalmitis / Q000188:drug therapy* / Q000517:prevention & control*; D005143:Eyelids / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011182:Postoperative Care; D011206:Povidone-Iodine / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine