Efficacy of intraoperative vancomycin in irrigating solutions on aqueous contamination during phacoemulsification.
OBJECTIVE
To study the efficacy of adding vancomycin in irrigating solutions, in comparison to topical antibiotic given preoperatively for a day, during phacoemulsification, in reducing the anterior chamber (AC) contamination.


METHODS
This was a prospective, interventional, hospital-based study.


METHODS
This was a study involving 400 eyes of 400 paitens, undergoing routine phacoemulsification between January 2004 and June 2006. The patients were non-randomly assigned to two groups: Group 1 included 180 patients, who received topical ciprofloxacin eye-drops (four-hourly) for a day preoperatively and Group 2 included 220 patients, who underwent phacoemulsification with vancomycin (20 microg/ml) in the irrigating solution. Anterior chamber aspirate obtained at the end of the surgery was sent for microbial workup. The number of positive cultures in both the groups was determined.


METHODS
This was performed using Chi-square test.


RESULTS
Aqueous samples showed microbial growth in 38 (21.1%) out of 180 eyes in Group 1 and in 17 (7.7%) out of 220 eyes in Group 2 ( P = 0.001). Coagulase-negative staphylococcus was the most common organism in both the groups. Aqueous samples from four eyes in group 1 showed multiple organisms, while none of the sample from group 2 showed more than one organism. None of the eyes in either group showed fungal contamination. One patient in Group 1 developed endophthalmitis, and the causative organism was Alcaligenes faecalis. All patients were followed up for a minimum of six months (range: 6 to 14 months and mean: 9.3 months).


CONCLUSIONS
Addition of vancomycin in irrigating solutions is more efficacious in reducing AC contamination in comparison to topical antibiotic administered a day preoperatively.
Srinivasan
Renuka
R
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry - 605 006, India.
Gupta
Arvind
A
Kaliaperumal
Subashini
S
Babu
Ramesh K
RK
Thimmarayan
Senthil Kumar
SK
Belgode
Harish Narasimha
HN
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000187:drug effects / Q000382:microbiology*; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control; D013210:Staphylococcus / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D014640:Vancomycin