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Y. Kusano, T. Aiki, S. Kogure, T. Yamaguchi; Bacterial Strains of the Meibomian Gland Secretion at the Conclusion of Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):202.
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Purpose: To investigate the bacterial strains of meibomian gland secretion at the conclusion of cataract surgery with intraocular lens implantation. Methods: Ninety-eight consecutive eyes of 96 patients having planned cataract surgery (95 phacoemulsification, 3 extracapsular cataract extraction) with intraocular lens implantation were included in this prospective study. Meibomitis was not observed clinically in any cases before cataract surgery. No patient required an anterior vitrectomy. Secretion from meibomian gland at the upper and lower lid margin was obtained with cotton swab at the conclusion of surgery. 0.2ml of aqueous humor was also obtained from 58 patients at the end of surgery. These were sent to the microbiology laboratory for the culture. All samples were investigated for aerobe and anaerobe microorganisms. MICs of several antibiotics for isolated microorganism were measured. Results: Twenty-four eyes out of 98 eyes (24%) had positive culture from meibomian gland secretion at the end of surgery. Staphylococcus epidermidis had the highest incidence (n=11, 42%) followed by Propionibacterium acnes (n=8, 31%), Propionibacterium granulosum (n=2), Staphylococcus aureus (n=1), Staphylococcus capitis (n=1), Streptococcus canis (n=1), Proteus vulgaris (n=1), Serratia marcescence (n=1). The MICs for Staphylococcus epidermidis strains were: CEZ 0.25-2, ABPC 0.06-16, TOB 0.06->64, AMK 0.25-8, CAZ 4-32, VCM 0.5-2, FMOX 0.5-16 and OFLX 0.25-16mg/l. The MICs for P. acnes strains were: CEZ 0.5-1, ABPC 0.125-0.5, CAZ 2-8, VCM 0.25-0.50, FMOX 0.031-0.125 and OFLX 1mg/l. No positive culture was found from aqueous humor samples. No patient developed postoperative endophthalmitis. Conclusions: Staphylococcus epidermidis and Propionibacterium species were the main bacterial strains of meibomian gland secretion at the conclusion of cataract surgery. The bacterial strains of the meibomian gland secretion was resemble to that of conjunctival flora therefore, bacterial contamination of the conjunctival flora seems to be influenced by meibomian gland secretion during the cataract surgery.
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