Comparison of Culture Results after Preoperative Chemical Preparation of The Eye in Cataract Surgery

ABSTRACT

Postoperative endophthalmitis is one of the devastating complications following cataract surgery. Ocular flora has been presumed to be a major source of infectious organisms in postoperative endophthalmitis. We compared the efficacies of various chemical preparation methods that decrease or eradicate ocular flora effectively before surgery. 355 eyes undergoing cataract surgery were randomly divided into 4 groups according to chemical preparation methods. 0.3% gentamicin eyedrop was used in group 1, 0.3% ciprofloxacin eyedrop in group 2, 0.3% gentamicin eyedrop and 5.0% povidone-iodine solution in group 3, and 0.3% ciprofloxacin eyedrop and 5.0% povidone-iodine solution were used in group 4 to prepare eye before surgery. Cultures of eyelid-conjunctival swab and aqueous humor were performed just before operation and at the time of wound closure, respectively, and then compared among 4 groups. The culturepositive rate was the lowest in group 4 and increased in group 3, group 2, and group 1 in a order. The culture-positive rate from the eyelid-conjunctiva in group 2 was significantly lower than that in group 1(p<0.05). The culture positive rates in the groups(group 3, 4) using the combination of antibiotics eyedrop and povidone-iodine solution for chemical preparation were significantly lower than those in the groups(group 1, 2) using antibiotics eyedrop only(p<0.05). The culture results of aqueous humor showed similar pattern as those from the eyelid-conjunctival swab. This study suggests that combined use of 0.3% ciprofloxacin eyedrop and 5.0% povidone-iodine solution is an effective and recommendable preoperative chemical preparation.