title: Residual lens cortex material: potential risk factor for endophthalmitis after phacoemulsification cataract surgery.
abstract: OBJECTIVE
  To evaluate the bacterial growth potential of residual lens cortex after phacoemulsification with the development of endophthalmitis.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Staphylococcus aureus and Staphylococcus epidermidis were dispensed into aqueous humor or serial dilutions of lens cortex that were obtained from cataract patients during phacoemulsification. After a 24-hour incubation, the colony-forming unit (CFU) was quantified. Eighty rabbits had phacoemulsification. Complete lens cortex removal was performed in 40 rabbits, while a quarter of lens cortex was retained in 40 rabbits. Staphylococcus aureus, with an inoculum size of 32 CFU, 56.3 CFU, and 108.6 CFU, was injected intracamerally at the conclusion of surgery and the production of endophthalmitis was measured 72 h later. The aqueous and vitreous humor samples were collected for microbiological diagnosis.
  
  
  RESULTS
  The increase in bacterial growth of S aureus and S epidermidis was statistically significantly greater in each dilution of lens cortex than in aqueous humor (P < .001, Student t test). With inoculum of 32.0 CFU or 56.3 CFU of S aureus, there was a statistically higher incidence of bacterial culture-proven endophthalmitis in the residual lens cortex eye group than in the normal aphakic eye group (P < .05, Fisher exact test).
  
  
  CONCLUSIONS
  Lens cortex was associated with a significant increase in bacterial growth compared with aqueous humor. Therefore, eyes with residual lens cortex seem more prone to develop endophthalmitis if anterior chamber bacterial contamination occurs during phacoemulsification.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Bingsheng
authors.initials: B
authors.lastname: Lou
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Lin
authors.forename: Lixia
authors.initials: L
authors.lastname: Luo
authors.forename: Yao
authors.initials: Y
authors.lastname: Yang
authors.forename: Yanting
authors.initials: Y
authors.lastname: Chen
authors.forename: Yizhi
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000818:Animals; D001082:Aqueous Humor / Q000382:microbiology; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000382:microbiology* / Q000473:pathology / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000382:microbiology* / Q000473:pathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007904:Lens Cortex, Crystalline / Q000382:microbiology* / Q000473:pathology; D007906:Lens Subluxation / Q000209:etiology; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects*; D011817:Rabbits; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000473:pathology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000254:growth & development* / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000254:growth & development