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Takahiro Hiraoka, Sujin Hoshi, Kuniharu Tasaki, Yuichi Kaji, Masao Maruyama, Tetsuro Oshika; Conjunctival bacterial flora in eyes with lacrimal passage obstruction before and after successful endoscopic recanalization. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6255.
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© ARVO (1962-2015); The Authors (2016-present)
Surgical treatments for lacrimal passage obstruction can be roughly divided into bypass surgery and reconstructive surgery. Bypass surgery with dacryocystorhinostomy (DCR) used to be a primary surgical treatment for such patients. However, owing to the invasive procedure, reconstructive surgery with dacryoendoscope has been widely employed in recent years. Although several researchers examined the change in conjunctival bacterial flora after DCR, there has been no study that investigated the change after reconstructive surgery with dacryoendoscope. The purpose of this study is to investigate conjunctival bacterial flora in eyes with lacrimal passage obstruction before and after successful endoscopic recanalization.
One-hundred fifty eyes of 150 patients (73.4 ± 8.6 years) with lacrimal passage obstruction, which were successfully treated by endoscopic recanalization with silicone tube intubation, were enrolled. Before and 4 to 6 months after the operation, the lower fornix was rubbed by a sterile cotton swab with topical anesthetic instillation, and the collected samples were sealed in tube containing a transport medium and were sent to the laboratory to perform bacteriological cultures. Following the incubation period of 48 h, colonies were differentiated and enumerated by standard bacteriological laboratory techniques. As for the postoperative assessment, conjunctival samples were collected at least one month after removing silicone tube.
Positive bacterial growth (isolation rate) was detected in 42% of all the samples preoperatively, which significantly decreased to 26% postoperatively (P < .01). The number of detected strains also decreased from 20 preoperatively to 9 postoperatively, especially pathogenic microorganism such as gram-negative bacilli and gram-positive cocci decreased. Coagulase-negative Staphylococci, Corynebacterium species, and Staphylococcus aureus, which are common in normal bacterial flora of human conjunctiva, accounted for 52% of all the isolates preoperatively and 87% postoperatively, showing a significant increase in the rate after surgery (P < .01).
This study showed that physiological recanalization of lacrimal passage after endoscopic surgery with silicone tube intubation caused normalization of conjunctival bacterial flora.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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