Analysis of Intraocular Lens Biofilms and Fluids After Long-Term Uncomplicated Cataract Surgery.
Postoperative endophthalmitis is a potentially sight-threatening complication of cataract surgery. However, the pathophysiological mechanisms are not completely understood. We sought to study and evaluate the intraocular environment (aqueous and vitreous humors), the capsular tissue, and the intraocular lens (IOL) surfaces of normal eyes after long-term uncomplicated cataract surgery.



Experimental laboratory investigation.



We studied 69 eyes donated for transplantation that had previously undergone cataract surgery with posterior chamber IOL implantation and that had no recorded clinical history of postoperative inflammation. We assessed the intraocular environment (DNA traces and biofilm formation) by microbiological evaluation of intraocular fluids using conventional microbiology and molecular techniques, including assessment for the presence of microbes (biofilm formation) on the IOL surface by scanning electron microscopy and ultrastructural capsular remnants by transmission electron microscopy.



Isolated or aggregated cocci were probable in 18.8% of IOL optic surfaces (n = 13) studied by scanning electron microscopy, suggesting the presence of bacterial biofilm. In 3 intraocular fluid samples for IOLs with biofilm, we identified 16S rDNA by polymerase chain reaction and sequencing. No microbial contamination was found in intraocular fluids by conventional microbiological methods.



Our data suggest the possibility of bacterial biofilm formation on the optic surface of IOLs in normal eyes after long-term uncomplicated cataract surgery even in the absence of clinical or subclinical symptoms.
CellTec-UB, University of Barcelona, Barcelona, Spain.
Paloma
P
Mazoteras
Special Laboratory of Clinical Microbiology (LEMC) & Laboratory of Ocular Microbiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Milene Gonçalves
MG
Quiles
Special Laboratory of Clinical Microbiology (LEMC) & Laboratory of Ocular Microbiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Paulo José
PJ
Martins Bispo
Special Laboratory of Clinical Microbiology (LEMC) & Laboratory of Ocular Microbiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Ana Luisa
AL
Höfling-Lima
Special Laboratory of Clinical Microbiology (LEMC) & Laboratory of Ocular Microbiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Antonio C
AC
Pignatari
Department of Surgery (School of Medicine) & Hospital Clínic de Barcelona (IDIBAPS), University of Barcelona, Barcelona, Spain; CellTec-UB, University of Barcelona, Barcelona, Spain. Electronic address: rcasaroli@ub.edu.
Ricardo P
RP
Casaroli-Marano
D001082:Aqueous Humor / Q000382:microbiology*; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification* / Q000648:ultrastructure; D018441:Biofilms / Q000254:growth & development*; D002387:Cataract Extraction; D004269:DNA, Bacterial / Q000235:genetics; D004275:DNA, Ribosomal / Q000235:genetics; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000382:microbiology / Q000648:ultrastructure; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000382:microbiology*; D008855:Microscopy, Electron, Scanning; D016133:Polymerase Chain Reaction; D019591:Pseudophakia / Q000382:microbiology; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D014019:Tissue Donors; D014822:Vitreous Body / Q000382:microbiology*
D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S