Comparison of preoperative anti-infective preparations for extracapsular lens extraction

Harvey S. Uy, MD; Roslyn D. Rodriguez, MD; Jacinto U.  Dy-Liacco, MD

Authors

Harvey S. Uy, MD Department of Ophthalmology and Visual Sciences Author
Roslyn D. Rodriguez, MD Department of Laboratories University of the Philippines– Philippine General Hospital Manila, Philippines Author
Jacinto U. Dy-Liacco, MD Department of Ophthalmology and Visual Sciences; Institute of Ophthalmology University of the Philippines– National Institutes of Health Manila, Philippines Author

Keywords:

Extracapsular lens extraction, Cataract, Endophthalmitis, Neomycin, Polymixin, Gramicidin, Bacitracin

Abstract

Objective: To investigate the effect of three preoperative anti-infective regimens on the sterility of anterior-chamber aspirates (ACA) in eyes undergoing extracapsular cataract extraction (ECCE).

Methods: Ninety eyes scheduled to undergo ECCE were randomly assigned to receive one of the following preoperative anti-infective regimens: Group 1 (Control) – no additional preoperative preparation; Group 2 (Eye drop) – neomycin/ polymixin B/gramicidin eye drops applied 3 times daily for 3 days prior to surgery; and Group 3 (Lid scrub) – neomycin/polymixin B/ bacitracin ointment lid scrub applied 3 times prior to surgery. ACAs were obtained from all eyes at the conclusion of surgery and cultured. The patients were followed up for 3 months after the surgery.

Results: Positive cultures developed from ACAs in 5 (16.6%) of 30 eyes from Group 1, in 0 of 30 from Group 2, and in 3 (10%) of 30 from Group 3. No eye developed endophthalmitis. Compared with the control group, preoperative neomycin/polymixin B/gramicidin eye drops significantly reduced the ACA contamination rate (p = 0.03).

Conclusion: Preoperative neomycin/polymixin B/bacitracin eyedrops can improve the sterility of the anterior chamber during ECCE.