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Study of Antibiotics and Conjunctival Sac Wash Before Cataract Surgery

Author: XiaXiaoHua
Tutor: LiaoRongFeng
School: Anhui Medical University,
Course: Ophthalmology
Keywords: Cataract surgery Conjunctival sac Levofloxacin Tobramycin Saline Gentamicin PVP-1 Bacterial culture
CLC: R779.66
Type: Master's thesis
Year: 2009
Downloads: 67
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Abstract

Introduction: cataract (catarct), is one of the major cause of blindness in China, surgery is the only effective means of cataract patients Fuming. Endophthalmitis bacterial eye (endophthalmitis) after cataract surgery serious complications (complication), the event will seriously affect the postoperative visual function (visual function), or even catastrophic consequences to the patient. Therefore the prevention of the occurrence of inflammation is an important part of the work of clinical ophthalmology cataract surgery bacterial eye. Reported both at home and abroad that the pathogens of bacterial eye inflammation from the conjunctival sac (conjunctival sac), conjunctival sac before cataract surgery sterile preparation is very important, the use of antibiotics (antibiotics) and conjunctival sac washing (conjunctival sac wash) preventive measures before cataract surgery. Understanding of cataract preoperative conjunctiva of the bacterial species and their drug-sensitive help to guide the preoperative medication, the prevention of the occurrence of bacterial endophthalmitis eye and early clinical significance. Reported on the use of antibiotics and conjunctival sac before cataract surgery flushing effect vary widely. Therefore, to explore the use of antibiotics before cataract surgery reasonable and effective the conjunctival sac flushing agent, has a very important reference value in clinical practice. Objective: through the acquisition of the conjunctival sac specimens for bacterial culture to understand before cataract surgery in patients with conjunctival sac bacteria constitute. Compare cataract surgery using two antibiotics and the three the conjunctival sac rinse agent's effect to guide clinical rational drug use. Anterior chamber fluid for bacterial culture taken at the end of surgery, anterior chamber contamination was observed. Methods: scheduled for cataract surgery were 156 cases (201) collected conjunctival sac specimens for bacterial culture, and then the patients were randomly divided into two groups, respectively, levofloxacin and tobramycin eye drops given before surgery three days, every day 4 times, the conjunctival sac of specimens collected after treatment for bacterial culture. Then each group were randomly divided into three groups, respectively disinfection before surgery with saline, gentamicin and polyethylene adjacent polyvinylpyrrolidone iodine (PVP-I) do conjunctival sac flushing conjunctival sac specimens were collected before and after flushing bacteria culture, surgery acquisition anterior chamber fluid bacterial culture and collected one day after the conjunctival sac of specimens for bacterial culture. Results: cataract patients before the 201 cases in the conjunctival sac specimens the 113 specimens bacterial cultures were positive, the positive rate was 56.2%, the bacteria mainly caused by gram-positive bacteria constitute (91.1%) (G), Staphylococcus epidermidis (47.8% ) and Staphylococcus aureus (19.5%). Cataract before and after the use of levofloxacin in patients with preoperative conjunctival sac bacteria culture positive rate of 56.0% and 33.0%, respectively, before and after the use of tobramycin conjunctival sac bacterial culture positive rate of 56.4% and 34.7%, respectively, before and after treatment were significantly different (P lt; 0.05), but between the two groups showed no significant difference; I group preoperative saline, gentamicin and PVP-1 wash conjunctival sac, rinse before and after the conjunctival sac of the bacterial culture positive rate were 34.4% and 12.5% , 29.4% and 8.8%, 35.3% and 0%, both statistically significant difference (P lt; 0.05), the flushing effect; better than A, B group C group effect. The three groups of conjunctival sac washing before and after bacteria positive rate in group II were 37.5% and 15.6%, 32.4% and 8.8%, 34.3% and 0%, both statistically significant difference (P lt; 0.05), description of the flushing effect Well; better than A, B group C group effect. The three sets of irrigation fluid showed no obvious side effects. The 72 rows phacoemulsification patients Acquisition anterior chamber fluid for bacterial culture, all the results were negative, including 37 of the 35 group Ⅰ, Ⅱ group, all results were negative, the groups showed no significant difference (P gt; 0.05 ). One day after the conjunctival sac of a bacterial culture-positive for 14 (7.0%), of which 5 (5.0%) in group Ⅰ, group II, 9 (8.9%) groups showed no significant difference (P gt; 0.05). Conclusion: Cataract the preoperative conjunctival sac of the bacteria is mainly constituted by the Gram-positive (G) bacteria, Staphylococcus epidermidis and Staphylococcus aureus. Levofloxacin and tobramycin are cleared before cataract surgery conjunctival sac bacteria effective antibiotics, saline, gentamicin and polyvinyl pyrrolidone iodine (PVP-I) can be used for flushing conjunctival sac before cataract surgery, but PVP-I is better than the other two. The three sets of irrigation fluid showed no obvious side effects. Preoperative antibiotic eye drops to eliminate the conjunctival sac bacteria, the conjunctival sac in a relatively sterile state, strict aseptic surgery, postoperative routine use of antibiotics in order to prevent the occurrence of endophthalmitis.

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CLC: > Medicine, health > Ophthalmology > Eye surgery and surgery > Cataract surgery
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