Comparison of Preoperative 3–day Topical Levofloxacin versus 1–day Topical Sisomicin Sulfate in the Reduction of Bacterial Flora on Conjunctiva at the End of Cataract Surgery

Abstract

Abstract: : Purpose: To determine the efficacy of reducing conjunctival bacterial flora on the human conjunctiva at the end of cataract surgery after treatment with 3–day topical levofloxacin compared with 1–day topical sisomicin sulfate. Methods: One hundred and seventy–five consecutive eyes of 175 patients having planned cataract surgery (phacoemulsification) with intraocular lens implantation were included in this study. In the study group, 77 eyes of 77 consecutive patients were given topical levofloxacin for three days before cataract surgery. Ninety–eight eyes of 98 patients who received topical sisomicin sulfate four times from one day before surgery were served as a control. All patients received 10% povidone–iodine scrub of the periorbital area before surgery. Conjunctival smears were obtained at the conclusion of surgery. These were sent to the microbiology laboratory for the culture. All samples were investigated for aerobe and anaerobe microorganisms. Results: Four percent (3/77) of eyes in the study group (3–day instillation of levofloxacin) had positive conjunctival culture at the conclusion of surgery, compared with 25% (24/98) of eyes in the control group (1–day instillation of sisomicin sulfate). Compared to 1–day instillation of topical sisomicin sulfate, pre–operative 3–day topical levofloxacin produced a significant reduction in bacterial flora in conjunctiva at the conclusion of cataract surgery. (P<0.001) None of the patient developed postoperative endophthalmitis in both groups. Conclusions: 3–day instillation of levofloxacin before surgery appears to be more effective in eliminating bacteria from conjunctiva than an application of 1–day sisomicin sulfate before surgery.

Keywords: antibiotics/antifungals/antiparasitics • cataract • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled