Anterior chamber contamination during cataract surgery with intraocular lens implantation
Purpose: To measure anterior chamber bacterial and fungal contamination at the beginning and end of cataract surgery with intraocular lens (IOL) implantation in a large series of patients and to determine the influence of preoperative treatment and operative technique on contamination. Setting: Depa...
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| Veröffentlicht in: | Journal of cataract and refractive surgery 1997-09, Vol.23 (7), p.1064-1069 |
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| creator | Mistlberger, Andrea Ruckhofer, Josef Raithel, Erich Müller, Manfred Alzner, Egon Egger, Stefan F. Grabner, Günther |
| description | Purpose: To measure anterior chamber bacterial and fungal contamination at the beginning and end of cataract surgery with intraocular lens (IOL) implantation in a large series of patients and to determine the influence of preoperative treatment and operative technique on contamination.
Setting: Department of Ophthalmology, County Hospital of Salzburg, Austria.
Methods: This prospective study comprised 700 consecutive patients having planned cataract extraction (511 phacoemulsification, 189 extracapsular cataract extraction [ECCE]). Thirty-four patients required an anterior vitrectomy; 8 myopic patients did not receive an IOL. A preoperative smear and two intraoperative (at the beginning and end of surgery) anterior chamber aspirates were obtained from each patient. Postoperative smears were obtained at discharge. Three preoperative treatments were evaluated: no lacrimal system irrigation, no topical antibiotic (n = 282); lacrimal system irrigation with balanced saline solution, no topical antibiotic (n = 243); lacrimal system irrigation, antibiotic (neomycin) eyedrops (n = 175). All patients received topical indomethacin twice a day preoperatively.
Results: Preoperative conjunctival smears showed bacterial growth in 76.6% of eyes, with coagulase-negative staphylococci (75%) the most common bacteria. Anterior chamber aspirates were culture positive in 14.1 % at the beginning and in 13.7% at the end of surgery, with coagulase-negative staphylococci and corynebacteria the most common. Contamination rates of conjunctival smears taken at discharge were significantly lower (35%) than those taken preoperatively. There was no statistically significantly higher risk of anterior chamber contamination in eyes having ECCE than in those having phacoemulsification. Preoperative treatment did not statistically significantly influence intraoperative aqueous humor contamination rates. There were no cases of acute postoperative endophthalmitis.
Conclusion: Bacteria entered the anterior chamber during cataract extraction and remained there at the end of surgery in a significant percentage of patients. Surgical technique, preoperative antibiotics, and preoperative lacrimal system irrigation had no statistically significant effect on contamination. |
| doi_str_mv | 10.1016/S0886-3350(97)80081-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79393324</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0886335097800818</els_id><sourcerecordid>79393324</sourcerecordid><originalsourceid>FETCH-LOGICAL-c389t-104fd000beff50b01b6149de0826ed1379db5725b6f5ebdc0b506340612c18d53</originalsourceid><addsrcrecordid>eNqFkM1q3DAURkVISSbTPsKAFyE0CydXlmXLqxJC0gYCXTRddCX0cz2jYMtTSW7J21eTGWZbENzFPZ_06RCyonBDgTa3P0CIpmSMw-euvRYAgpbihCyoaFlZc6hOyeKInJOLGF8BoK4YPyNnHWvzEQvy684nDG4KhdmoUWOek09qdF4lN_nCzsH5dWFUUkGZVMQ5rDG8FX9d2hTOp6AmMw8qFAP6WLhxO6gc30U_kg-9GiJ-Oswl-fn48HL_rXz-_vXp_u65NEx0qaRQ9zYX09j3HDRQ3dC6swiiatDS3NNq3lZcNz1HbQ1oDg2roaGVocJytiRX-3u3Yfo9Y0xydNHgkIvgNEeZP9oxVtUZ5HvQhCnGgL3cBjeq8CYpyJ1S-a5U7nzJrpXvSqXIudXhgVmPaI-pg8O8vzzsVTRq6IPyxsUjVgnOWc0y9mWPYZbxx2GQ0Tj0Bq0LaJK0k_tPkX_Z-5Q3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>79393324</pqid></control><display><type>article</type><title>Anterior chamber contamination during cataract surgery with intraocular lens implantation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Mistlberger, Andrea ; Ruckhofer, Josef ; Raithel, Erich ; Müller, Manfred ; Alzner, Egon ; Egger, Stefan F. ; Grabner, Günther</creator><creatorcontrib>Mistlberger, Andrea ; Ruckhofer, Josef ; Raithel, Erich ; Müller, Manfred ; Alzner, Egon ; Egger, Stefan F. ; Grabner, Günther</creatorcontrib><description>Purpose: To measure anterior chamber bacterial and fungal contamination at the beginning and end of cataract surgery with intraocular lens (IOL) implantation in a large series of patients and to determine the influence of preoperative treatment and operative technique on contamination.
Setting: Department of Ophthalmology, County Hospital of Salzburg, Austria.
Methods: This prospective study comprised 700 consecutive patients having planned cataract extraction (511 phacoemulsification, 189 extracapsular cataract extraction [ECCE]). Thirty-four patients required an anterior vitrectomy; 8 myopic patients did not receive an IOL. A preoperative smear and two intraoperative (at the beginning and end of surgery) anterior chamber aspirates were obtained from each patient. Postoperative smears were obtained at discharge. Three preoperative treatments were evaluated: no lacrimal system irrigation, no topical antibiotic (n = 282); lacrimal system irrigation with balanced saline solution, no topical antibiotic (n = 243); lacrimal system irrigation, antibiotic (neomycin) eyedrops (n = 175). All patients received topical indomethacin twice a day preoperatively.
Results: Preoperative conjunctival smears showed bacterial growth in 76.6% of eyes, with coagulase-negative staphylococci (75%) the most common bacteria. Anterior chamber aspirates were culture positive in 14.1 % at the beginning and in 13.7% at the end of surgery, with coagulase-negative staphylococci and corynebacteria the most common. Contamination rates of conjunctival smears taken at discharge were significantly lower (35%) than those taken preoperatively. There was no statistically significantly higher risk of anterior chamber contamination in eyes having ECCE than in those having phacoemulsification. Preoperative treatment did not statistically significantly influence intraoperative aqueous humor contamination rates. There were no cases of acute postoperative endophthalmitis.
Conclusion: Bacteria entered the anterior chamber during cataract extraction and remained there at the end of surgery in a significant percentage of patients. Surgical technique, preoperative antibiotics, and preoperative lacrimal system irrigation had no statistically significant effect on contamination.</description><identifier>ISSN: 0886-3350</identifier><identifier>EISSN: 1873-4502</identifier><identifier>DOI: 10.1016/S0886-3350(97)80081-8</identifier><identifier>PMID: 9379378</identifier><identifier>CODEN: JCSUEV</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anterior Chamber - microbiology ; Anti-Bacterial Agents - administration & dosage ; Bacteria - isolation & purification ; Biological and medical sciences ; Cataract Extraction - adverse effects ; Colony Count, Microbial ; Conjunctiva - microbiology ; Endophthalmitis - microbiology ; Endophthalmitis - prevention & control ; Eye Infections, Bacterial - etiology ; Eye Infections, Bacterial - prevention & control ; Eye Infections, Fungal - etiology ; Eye Infections, Fungal - prevention & control ; Female ; Humans ; Lens Implantation, Intraocular ; Male ; Medical sciences ; Middle Aged ; Neomycin - administration & dosage ; Ophthalmic Solutions ; Prospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the eye and orbit ; Vitrectomy]]></subject><ispartof>Journal of cataract and refractive surgery, 1997-09, Vol.23 (7), p.1064-1069</ispartof><rights>1997 American Society of Cataract and Refractive Surgery and European Society of Cataract and Refractive Surgeons. All rights reserved</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-104fd000beff50b01b6149de0826ed1379db5725b6f5ebdc0b506340612c18d53</citedby><cites>FETCH-LOGICAL-c389t-104fd000beff50b01b6149de0826ed1379db5725b6f5ebdc0b506340612c18d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0886335097800818$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2855343$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9379378$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mistlberger, Andrea</creatorcontrib><creatorcontrib>Ruckhofer, Josef</creatorcontrib><creatorcontrib>Raithel, Erich</creatorcontrib><creatorcontrib>Müller, Manfred</creatorcontrib><creatorcontrib>Alzner, Egon</creatorcontrib><creatorcontrib>Egger, Stefan F.</creatorcontrib><creatorcontrib>Grabner, Günther</creatorcontrib><title>Anterior chamber contamination during cataract surgery with intraocular lens implantation</title><title>Journal of cataract and refractive surgery</title><addtitle>J Cataract Refract Surg</addtitle><description>Purpose: To measure anterior chamber bacterial and fungal contamination at the beginning and end of cataract surgery with intraocular lens (IOL) implantation in a large series of patients and to determine the influence of preoperative treatment and operative technique on contamination.
Setting: Department of Ophthalmology, County Hospital of Salzburg, Austria.
Methods: This prospective study comprised 700 consecutive patients having planned cataract extraction (511 phacoemulsification, 189 extracapsular cataract extraction [ECCE]). Thirty-four patients required an anterior vitrectomy; 8 myopic patients did not receive an IOL. A preoperative smear and two intraoperative (at the beginning and end of surgery) anterior chamber aspirates were obtained from each patient. Postoperative smears were obtained at discharge. Three preoperative treatments were evaluated: no lacrimal system irrigation, no topical antibiotic (n = 282); lacrimal system irrigation with balanced saline solution, no topical antibiotic (n = 243); lacrimal system irrigation, antibiotic (neomycin) eyedrops (n = 175). All patients received topical indomethacin twice a day preoperatively.
Results: Preoperative conjunctival smears showed bacterial growth in 76.6% of eyes, with coagulase-negative staphylococci (75%) the most common bacteria. Anterior chamber aspirates were culture positive in 14.1 % at the beginning and in 13.7% at the end of surgery, with coagulase-negative staphylococci and corynebacteria the most common. Contamination rates of conjunctival smears taken at discharge were significantly lower (35%) than those taken preoperatively. There was no statistically significantly higher risk of anterior chamber contamination in eyes having ECCE than in those having phacoemulsification. Preoperative treatment did not statistically significantly influence intraoperative aqueous humor contamination rates. There were no cases of acute postoperative endophthalmitis.
Conclusion: Bacteria entered the anterior chamber during cataract extraction and remained there at the end of surgery in a significant percentage of patients. Surgical technique, preoperative antibiotics, and preoperative lacrimal system irrigation had no statistically significant effect on contamination.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anterior Chamber - microbiology</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Bacteria - isolation & purification</subject><subject>Biological and medical sciences</subject><subject>Cataract Extraction - adverse effects</subject><subject>Colony Count, Microbial</subject><subject>Conjunctiva - microbiology</subject><subject>Endophthalmitis - microbiology</subject><subject>Endophthalmitis - prevention & control</subject><subject>Eye Infections, Bacterial - etiology</subject><subject>Eye Infections, Bacterial - prevention & control</subject><subject>Eye Infections, Fungal - etiology</subject><subject>Eye Infections, Fungal - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Lens Implantation, Intraocular</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neomycin - administration & dosage</subject><subject>Ophthalmic Solutions</subject><subject>Prospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the eye and orbit</subject><subject>Vitrectomy</subject><issn>0886-3350</issn><issn>1873-4502</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1q3DAURkVISSbTPsKAFyE0CydXlmXLqxJC0gYCXTRddCX0cz2jYMtTSW7J21eTGWZbENzFPZ_06RCyonBDgTa3P0CIpmSMw-euvRYAgpbihCyoaFlZc6hOyeKInJOLGF8BoK4YPyNnHWvzEQvy684nDG4KhdmoUWOek09qdF4lN_nCzsH5dWFUUkGZVMQ5rDG8FX9d2hTOp6AmMw8qFAP6WLhxO6gc30U_kg-9GiJ-Oswl-fn48HL_rXz-_vXp_u65NEx0qaRQ9zYX09j3HDRQ3dC6swiiatDS3NNq3lZcNz1HbQ1oDg2roaGVocJytiRX-3u3Yfo9Y0xydNHgkIvgNEeZP9oxVtUZ5HvQhCnGgL3cBjeq8CYpyJ1S-a5U7nzJrpXvSqXIudXhgVmPaI-pg8O8vzzsVTRq6IPyxsUjVgnOWc0y9mWPYZbxx2GQ0Tj0Bq0LaJK0k_tPkX_Z-5Q3</recordid><startdate>19970901</startdate><enddate>19970901</enddate><creator>Mistlberger, Andrea</creator><creator>Ruckhofer, Josef</creator><creator>Raithel, Erich</creator><creator>Müller, Manfred</creator><creator>Alzner, Egon</creator><creator>Egger, Stefan F.</creator><creator>Grabner, Günther</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970901</creationdate><title>Anterior chamber contamination during cataract surgery with intraocular lens implantation</title><author>Mistlberger, Andrea ; Ruckhofer, Josef ; Raithel, Erich ; Müller, Manfred ; Alzner, Egon ; Egger, Stefan F. ; Grabner, Günther</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-104fd000beff50b01b6149de0826ed1379db5725b6f5ebdc0b506340612c18d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anterior Chamber - microbiology</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Bacteria - isolation & purification</topic><topic>Biological and medical sciences</topic><topic>Cataract Extraction - adverse effects</topic><topic>Colony Count, Microbial</topic><topic>Conjunctiva - microbiology</topic><topic>Endophthalmitis - microbiology</topic><topic>Endophthalmitis - prevention & control</topic><topic>Eye Infections, Bacterial - etiology</topic><topic>Eye Infections, Bacterial - prevention & control</topic><topic>Eye Infections, Fungal - etiology</topic><topic>Eye Infections, Fungal - prevention & control</topic><topic>Female</topic><topic>Humans</topic><topic>Lens Implantation, Intraocular</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neomycin - administration & dosage</topic><topic>Ophthalmic Solutions</topic><topic>Prospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the eye and orbit</topic><topic>Vitrectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mistlberger, Andrea</creatorcontrib><creatorcontrib>Ruckhofer, Josef</creatorcontrib><creatorcontrib>Raithel, Erich</creatorcontrib><creatorcontrib>Müller, Manfred</creatorcontrib><creatorcontrib>Alzner, Egon</creatorcontrib><creatorcontrib>Egger, Stefan F.</creatorcontrib><creatorcontrib>Grabner, Günther</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cataract and refractive surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mistlberger, Andrea</au><au>Ruckhofer, Josef</au><au>Raithel, Erich</au><au>Müller, Manfred</au><au>Alzner, Egon</au><au>Egger, Stefan F.</au><au>Grabner, Günther</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anterior chamber contamination during cataract surgery with intraocular lens implantation</atitle><jtitle>Journal of cataract and refractive surgery</jtitle><addtitle>J Cataract Refract Surg</addtitle><date>1997-09-01</date><risdate>1997</risdate><volume>23</volume><issue>7</issue><spage>1064</spage><epage>1069</epage><pages>1064-1069</pages><issn>0886-3350</issn><eissn>1873-4502</eissn><coden>JCSUEV</coden><abstract>Purpose: To measure anterior chamber bacterial and fungal contamination at the beginning and end of cataract surgery with intraocular lens (IOL) implantation in a large series of patients and to determine the influence of preoperative treatment and operative technique on contamination.
Setting: Department of Ophthalmology, County Hospital of Salzburg, Austria.
Methods: This prospective study comprised 700 consecutive patients having planned cataract extraction (511 phacoemulsification, 189 extracapsular cataract extraction [ECCE]). Thirty-four patients required an anterior vitrectomy; 8 myopic patients did not receive an IOL. A preoperative smear and two intraoperative (at the beginning and end of surgery) anterior chamber aspirates were obtained from each patient. Postoperative smears were obtained at discharge. Three preoperative treatments were evaluated: no lacrimal system irrigation, no topical antibiotic (n = 282); lacrimal system irrigation with balanced saline solution, no topical antibiotic (n = 243); lacrimal system irrigation, antibiotic (neomycin) eyedrops (n = 175). All patients received topical indomethacin twice a day preoperatively.
Results: Preoperative conjunctival smears showed bacterial growth in 76.6% of eyes, with coagulase-negative staphylococci (75%) the most common bacteria. Anterior chamber aspirates were culture positive in 14.1 % at the beginning and in 13.7% at the end of surgery, with coagulase-negative staphylococci and corynebacteria the most common. Contamination rates of conjunctival smears taken at discharge were significantly lower (35%) than those taken preoperatively. There was no statistically significantly higher risk of anterior chamber contamination in eyes having ECCE than in those having phacoemulsification. Preoperative treatment did not statistically significantly influence intraoperative aqueous humor contamination rates. There were no cases of acute postoperative endophthalmitis.
Conclusion: Bacteria entered the anterior chamber during cataract extraction and remained there at the end of surgery in a significant percentage of patients. Surgical technique, preoperative antibiotics, and preoperative lacrimal system irrigation had no statistically significant effect on contamination.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9379378</pmid><doi>10.1016/S0886-3350(97)80081-8</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Anterior Chamber - microbiology Anti-Bacterial Agents - administration & dosage Bacteria - isolation & purification Biological and medical sciences Cataract Extraction - adverse effects Colony Count, Microbial Conjunctiva - microbiology Endophthalmitis - microbiology Endophthalmitis - prevention & control Eye Infections, Bacterial - etiology Eye Infections, Bacterial - prevention & control Eye Infections, Fungal - etiology Eye Infections, Fungal - prevention & control Female Humans Lens Implantation, Intraocular Male Medical sciences Middle Aged Neomycin - administration & dosage Ophthalmic Solutions Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the eye and orbit Vitrectomy |
| title | Anterior chamber contamination during cataract surgery with intraocular lens implantation |
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