title: Microbial cultures of the microkeratome blade immediately after flap construction in laser in situ keratomileusis.
abstract: OBJECTIVE
  To assess the incidence of positive cultures from samples of the microkeratome blade after routine laser in situ keratomileusis (LASIK) procedures as a measure of the risk for postoperative infectious keratitis.
  
  
  METHODS
  Hinsdale Surgical Center, Hinsdale, Illinois, USA.
  
  
  METHODS
  In this prospective study, 99 microkeratome blades (Hansatome) were cultured after routine LASIK procedures by multiple surgeons at an ambulatory surgery center. Cultures were sent for routine aerobic and anaerobic growth. Positive cultures were then sent for routine sensitivities.
  
  
  RESULTS
  Five of 99 swabs of microkeratome blades were culture positive. Four cultures grew Staphylococcus epidermidis and 1, Staphylococcus warneri. Two of the staphylococcal cultures were resistant to ciprofloxacin and levofloxacin but sensitive to moxifloxacin and gatifloxacin.
  
  
  CONCLUSIONS
  The study demonstrated a 5% positive culture rate from the microkeratome blade after routine LASIK surgery by multiple surgeons in an ambulatory surgery center. No patient with positive cultures developed postoperative infectious keratitis. Factors other than the presence of bacteria contribute to the development of clinical infection.
authors.affiliation: Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: Ahsan M
authors.initials: AM
authors.lastname: Khan
authors.forename: Bruce
authors.initials: B
authors.lastname: Larson
authors.forename: James
authors.initials: J
authors.lastname: Noth
authors.forename: Roger
authors.initials: R
authors.lastname: Rosen
authors.forename: Charles
authors.initials: C
authors.lastname: Bouchard
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques; D003320:Corneal Ulcer / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004866:Equipment Contamination; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D054018:Lasers, Excimer; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification* / Q000502:physiology; D013524:Surgical Flaps / Q000382:microbiology*