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Asuncion Peral, Cristina Niño-Rueda, Patricia Calvo del Bosque, Concepcion Garcia-Garcia; Qualitative and quantitative analysis of the eyelid and conjunctiva microbiota: importance of the lid hygiene before ocular surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2771.
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The aim of this work is to study the therapeutic effect of lid hygiene reducing the microbiota present in the eyelids and conjunctiva by using eyelid sterile wipes.
Interventional prospective clinical study phase IV of 47 patients (19males/28 females), age range 45-85 years. Sterile eyelid wipes containing a solution of hyaluronic acid, capriloilglicine, Florentine iris and Centella asiatica were used for 5 days twice a day in the selected eye. Microbiota samples were taken using sterile swabs from the surface of the eyelid and the inferior tarsal conjunctiva from both eyes days 0, 3 and 5. The non-treated eye was used as control. Samples were cultured for 48 hours at 37°C in specific culture media. Grown colonies were identified and photographed and the total area of microbial growth on the plates was analysed by ImageJTM software.
Day 0, microbial analysis showed similar profiles for eyelid and conjunctiva. Identified biota on the eyelid revealed the presence of Staphylococcus epidermidis (94.7% of the plaques) and Corynebacterium spp. (32.98% of the plaques) as the most frequent microorganisms. In a smaller percentage, Staphylococcus aureus, Micrococcus spp. and Bacillus spp. (6.38%, 8.51%, 1.06%, respectively) were isolated. In the conjunctiva Staphylococcus epidermidis and Corynebacterium spp. (54.26% and 38.29%) were identified as well as Staphylococcus aureus and Micrococcus spp. (5.32% and 1.06%). The growth areas on the plates showed a higher microbial load on eyelids (17.98%) versus conjunctiva (1.36%). Measurements performed at days 3 and 5 showed a mean reduction of 55% and 56% in the microbial load on the eyelid respectively (p< 0.0001) in the treated eyes. Conjunctiva microbiota presented a clear clinical reduction without statistical significance.
The protocol of eyelid hygiene followed in the present study reduced the microbiota of the eyelids and conjunctiva. These results give useful information suggesting the type of antibiotic prophylaxis to minimise postoperative infections (broad spectrum or preferably activity against Gram+ ) and to highlight the importance of preoperative eyelid hygiene
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