The efficacy of postenucleation saline wash and the effect of different antimicrobial agents on microbial contamination of donor eyes.
OBJECTIVE
To evaluate the efficacy of postenucleation saline wash and the effect of different antimicrobial agents on the microbial contamination of donor eyes.


METHODS
Two hundred donor eyes were given saline wash and treated with any one of the following 5 randomly selected antimicrobial solutions: 1% povidone-iodine for 3 min, 0.3% gentamycin for 10 min, 0.3% ciprofloxacin for 10 min, a combination of neomycin 1,700 IU, gramicidin 0.025% and polymyxin B 5,000 IU (Neosporin(R)) for 10 min and a combination of 0.3% amikacin for 10 min, followed by 2.5% cefazolin for 10 min. Limbal swabs were sent for culture before and after saline wash and after treatment with antimicrobial agents.


RESULTS
On culture of the pretreatment swabs, 77.5% were positive for growth with 75.5% bacterial and 11.5% fungal. Coagulase-negative Staphylococcus (29.1%) was the most common bacterial contamination followed by Pseudomonas aeruginosa (18.5%), Acinetobacter sp. (18.5%) and Alcaligenes faecalis (13.2%). A 20-ml sterile saline wash resulted in a 20% decrease (p < 0.01) in the amount of contamination. The maximum antimicrobial effect with regard to bacterial decontamination was achieved with povidone-iodine (64% decrease in the amount of contamination, p < 0.01) followed by ciprofloxacin (47.6% decrease, p < 0.05), the combination of cefazolin and amikacin (42.5%, p < 0.05), Neosporin (38.5%, p < 0.05) and then gentamycin (21.7%, p = NS).


CONCLUSIONS
A thorough saline wash and treatment with 1% povidone-iodine for 3 min is a more effective method for the decontamination of donor eyes as compared to most currently available and frequently used antibiotics.
Panda
Anita
A
Institute of Medical Sciences, All India Institute of Medical Sciences, New Delhi, India.
Saxena
Rohit
R
Vajpayee
Rasik B
RB
Satpathy
Gita
G
Angra
S K
SK
Sethi
Harinder Singh
HS
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003666:Decontamination / Q000379:methods; D005123:Eye / Q000382:microbiology*; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D012965:Sodium Chloride / Q000494:pharmacology*; D007507:Therapeutic Irrigation; D014019:Tissue Donors
D000900:Anti-Bacterial Agents; D012965:Sodium Chloride