title: Eyelid skin disinfecting and conjunctival bacteria in cataract surgery.
abstract: OBJECTIVE
  To evaluate the effect on conjunctival micro-organisms of chlorhexidine alcohol 0.5% eyelid wash in cataract patients.
  
  
  METHODS
  In this single-centre experimental study, 120 patients scheduled to undergo cataract operation were cultured in the conjunctiva before the operation and after the insertion of the intraocular lens. Bacterial samples for aerobic and anaerobic cultures were taken with a polyvinyl alcohol pad and transported in peptone water to the microbiological laboratory where they were analysed in a blinded fashion. Half of the patients received a standardized eyelid scrub with chlorhexidine alcohol 0.5%, while the rest did not. The conjunctiva of all patients was rinsed preoperatively with chlorhexidine solution 0.05%.
  
  
  RESULTS
  In all the between-group comparisons, the treated eyelid group had slightly lower bacterial counts than the control group on the postoperative samples, but differences were far from statistically significant. Within-group comparisons revealed statistically significant reduction in colonies and species between the preoperative and postoperative sampling.
  
  
  CONCLUSIONS
  In this experimental culture study, no evidence was found to suggest that preoperative eyelid chlorhexidine alcohol wash is effective in further reducing bacterial counts in the conjunctiva when the conjunctiva itself is rinsed preoperatively with chlorhexidine solution. The present results, however, do not contradict that the wash may be of some marginal help in reducing bacterial contamination of the operation field. Consequently, this part of the prophylactic protocol is still in practice in our institution.
authors.affiliation: Department of Ophthalmology St Erik Eye Hospital, Karolinska University Laboratory Stockholm, Stockholm, Sweden.
authors.forename: Talal
authors.initials: T
authors.lastname: Ali
authors.forename: Karin
authors.initials: K
authors.lastname: Jung
authors.forename: Per G
authors.initials: PG
authors.lastname: Montan
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002387:Cataract Extraction; D002710:Chlorhexidine / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology*; D004202:Disinfectants / Q000627:therapeutic use*; D004203:Disinfection / Q000379:methods; D005143:Eyelids / Q000187:drug effects* / Q000382:microbiology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D012867:Skin / Q000187:drug effects* / Q000382:microbiology; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D004202:Disinfectants; D002710:Chlorhexidine