Abstract
Abstract: :
Purpose: To determine the frequency of intraoperative contamination of the anterior chamber with viable microorganisms during cataract phacoemulsification and intraocular lens implantation in dogs and to evaluate the relationship of organisms isolated from the anterior chamber at the time of corneal closure to patient's conjunctival, eyelid margin, and nasal cavity floras. Methods: Twenty-two eyes from 13 dogs presented for elective cataract phacoemulsification and intraocular lens implantation were included in the study. Following presurgical preparation, sterile rayon swabs were used to swab the dorsal and ventral conjunctival sacs, superior and inferior eyelid margins, nares, and rostral nasal cavity. Immediately prior to final closure of the corneal incision, 0.1-0.2 ml of anterior chamber fluid was aspirated. Samples were submitted for aerobic/anaerobic bacteriologic culture and antimicrobial susceptibility, Mycoplasma culture, and fungal culture. Organisms recovered from the anterior chamber at the conclusion of surgery were compared to the patient's conjunctiva, eyelid margin, and nasal cavity floras. Antimicrobial susceptibility patterns were utilized to determine the similarity of identically typed bacterial organisms isolated from both the anterior chamber and the conjunctiva, eyelid margin, and/or nasal cavity in the same patient. Results: Anterior chamber aspirates collected at the conclusion of surgery were culture positive for at least one organism in 22.7% of eyes. Preoperative conjunctival and eyelid margin swabs were culture positive for at least one organism in 90.9% of eyes. Nasal cavity and nares swabs were culture positive for multiple organisms in 100.0% of patients. Three aerobic bacteria (Staphylococcus epidermidis, Pantoea agglomerans, and Bacillus sp.) and three fungi (Scopulariopsis sp. and two Cladosporium spp.) were isolated from the anterior chamber aspirates. No Mycoplasma organisms were cultured from the anterior chamber aspirates. Two fungi and one bacterium isolated from the anterior chamber were typed identically, and the bacterium had a similar antibiogram, to organisms recovered from the patient's conjunctiva and eyelid margin. Conclusions: Intraoperative contamination of the anterior chamber with bacterial and fungal organisms occurs in a significant percentage of canine patients undergoing cataract phacoemulsification and intraocular lens implantation and the external ocular flora is a likely source of some of these contaminating microorganisms.
Keywords: treatment outcomes of cataract surgery • endophthalmitis • cataract