May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
The Effect of Preop Lid Scrubs and Levofloxacin on Eyelid and Conjunctival Cultures Prior to Cataract Surgery
Author Affiliations & Notes
  • F.A. Bucci, Jr.
    Bucci Laser Vision Institute, Wilkes-Barre, PA, United States
  • L.M. Amico
    Bucci Laser Vision Institute, Wilkes-Barre, PA, United States
  • A. Guerino
    Bucci Laser Vision Institute, Wilkes-Barre, PA, United States
  • R. Evans
    Bucci Laser Vision Institute, Wilkes-Barre, PA, United States
  • Footnotes
    Commercial Relationships  F.A. Bucci, Jr., Santen R; L.M. Amico, None; A. Guerino, None; R. Evans, None.
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 1446. doi:
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      F.A. Bucci, Jr., L.M. Amico, A. Guerino, R. Evans; The Effect of Preop Lid Scrubs and Levofloxacin on Eyelid and Conjunctival Cultures Prior to Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1446.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To compare the efficacy of lid scrubs and levofloxacin for decreasing the bacterial load of the eyelids and conjunctiva prior to cataract surgery. Methods: 74 cataract patients were randomized into 4 groups. Group 1 (control) received no levofloxacin and performed no lid scrubs prior to cataract surgery. Group 2 (levo only) used levofloxacin for 2 days pre-op and 1 drop the morning of surgery. Group 3 (lid scrubs only) performed lid scrubs qhs for 2 nights pre-op. Group 4 (levo + lid scrubs) performed lid scrubs qhs x 2 nights and used levofloxacin 4 x day for 2 days preop and on the morning of cataract surgery. Conjunctival and eyelid cultures were obtained preop on the morning of surgery and the results were statistically analyzed. Results: The lid scrubs only group yielded the highest number of colony-forming units (mean=2493), 47% greater than the control group (mean=1695). The mean colony-forming units for levo alone was 1078, 36% less than the control group. Most interestingly, the mean colony-forming units for the levo + lid scrubs group was 279, 89% less than the lid scrubs only group, 84% less than the control group, and 74% less than the levo alone group. The difference between the control group and the levofloxacin + scrubs group was highly significant (p=.017), as was the difference between the lid scrubs alone and the levo + lid scrubs group (p=.005). The difference between the control group and the levofloxacin group just reached significance at a p-value of .049. A staph species was detected in 100% of specimens in Groups 1, 2, and 3. Staph species were detected in only 50% of specimens in Group 4 (levo + lid scrubs). Conclusions: The results of this study strongly suggest that performing lid scrubs preoperatively in the absence of a concomitant broad-spectrum antibiotic increases the risk of ocular infection prior to cataract surgery. However, the synergistic combination of lid scrubs and the use of a broad spectrum fluoroquinolone, such as levofloxacin, dramatically reduces the number of conjunctival and eyelid colony-forming units compared to all other methods tested.

Keywords: endophthalmitis • anterior segment • bacterial disease 
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