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J. Stein, R. Cykiert, P. Tierno; A Comparison of the Effectiveness of Eradicating Conjuncitval and Eyelid Margin Bacteria by Preoperative Instillation of Topical Ciprofloxacin Versus Preoperative Instillation of Ciprofloxacin Ointment in Patients Prior to Undergoing Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4002.
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Purpose: Currently, Ciprofloxacin eye drops and Ciprofloxacin eye ointment are used as appropriate ways of preventing infection in patients undergoing cataract surgery. The purpose of this study is to determine whether the eye drop or the ointment form of the same antibiotic is more effective at reducing bacterial counts at the eyelid margin and conjunctiva. Since many studies indicate that the infectious organism in endophthalmitis resides on the eyelashes and lid margin preoperatively, it would seem that an ointment antibiotic would be more effective at prophylaxis since it adheres significantly longer to these anatomic structures than the eye drop. Methods: In this prospective study, 50 patients with visually significant cataracts planning to undergo cataract extraction had a swabbing performed on their eyelid margin and conjunctiva of both eyes preoperatively. The patients were then instructed to put Ciprofloxacin ointment into the eye undergoing cataract surgery and Ciprofloxacin eye drops into the eye not receiving surgery. Immediately prior to surgery and before prepping the eye with betadine, a second set of swabs of the eyelid margin and conjunctiva of each eye was performed. Analysis of bacterial counts at the eyelid margin and conjunctiva was performed before and after instillation of the eye drops and ointment and a comparison performed to determine whether the eye drop or ointment is more effective at reducing bacterial counts. Results: The mean bacterial counts at the lid margin and conjunctiva were significantly lower in the eyes treated with Ciprofloxacin ointment as compared to the fellow eyes receiving Ciprofloxacin eye drops. Conclusions: Ciprofloxacin ointment may be more effective than Ciprofloxacin eye drops at preventing postoperative bacterial endophthalmitis in patients undergoing cataract surgery because it eradicates organisms that reside on the eye preoperatively.
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