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H. Miño de Kaspar, G. Singh, P.R. Egbert, W.W. Haw, E.V. Nguyen, K. Singh, M.S. Blumenkranz, C.N. Ta; Ten-Fold Reduction of Conjunctival Bacterial Contamination Rate Using a Combined 3-Day Application of Topical Ofloxacin and Iodine Irrigation in Patients Undergoing Anterior Segment Intraocular Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1457.
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Purpose: To determine the effectiveness of a prophylactic regimen for conjunctival bacterial load reduction, based on topical ofloxacin (0.3 %, 3 days) and 5% povidone-iodine irrigation of the conjunctival fornices prior to cataract surgery. Methods: Fifty patients scheduled for surgery were asked to enroll in this prospective study. All patients were treated with topical ofloxacin (4 times/day for 3 days and 3 times 1 hour prior to surgery). Using povidone iodine (PVI), the periorbital area was scrubbed and the conjunctival fornices were irrigated with 10 ml solution, 5 minutes prior surgery. Samples were obtained from conjunctiva at T0 (baseline, 5 days prior to surgery), T1 (after 3 days of topical ofloxacin), T2 (immediately before surgery) and T3 (at the conclusion of surgery) and from anterior chamber at T2 and T3. All specimens were cultured for 10 days at 35°C onto blood/chocolate agar plates, and blood culture broth (BLL Septi-Check®). Results: Five patients cancelled their surgery, resulting in 45 participants (Table1). Table 1. Positive: number of samples with positive culture result (Septi-Check broth); %Pos: Positives in relation to study group (N = 45); %Reduction: reduction of positive rate at T1, T2 and T3 compared to T0; P-value, significance of %Reduction (chi-square test). Frequency of isolated organisms: Staphylococcus epidermidis (60%), S. aureus (9%), Corynebacterium spp. (20%), Propionibacterium acnes (7%), Gram-negative rods (4%). All anterior chamber aqueous samples were sterile. Conclusion: A three-day application of ofloxacin significantly reduced the conjunctival bacterial contamination rate. Further reduction was achieved with the combined prophylaxis based on ofloxacin and PVI irrigation just prior to surgery. The complete regimen resulted in a reduction of culture positive samples from conjunctiva from 93% to 9%, with no bacterial contamination of the aqueous fluids. View OriginalDownload SlideView OriginalDownload Slide
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