Conjunctiva most likely source of organisms in endophthalmitis

SYDNEY, Australia — The conjunctiva is the most likely source of bacteria causing postoperative endophthalmitis, a study here confirmed. Povidone-iodine prep is helpful in reducing the conjunctival bacterial load, the study findings suggest.

Researchers here prospectively studied 98 eyes of 96 patients undergoing phacoemulsification with IOL implantation. Preoperative and postoperative conjunctival swabs were acquired. Two intraoperative anterior chamber aspirates were obtained from each patient, one at the start and one at the conclusion of the surgery. No preop antibiotics were used.

There was no intraoperative anterior chamber contamination; all anterior chamber samples were culture-negative. Of the preop conjunctival swabs, 65% were positive for growth, with corynebacteria, coagulase-negative staphylococci and Propionibacterium acnes the most frequently cultured organisms. Of the postop conjunctival swabs, 16% were positive for growth, with corynebacteria and coagulase-negative staphylococci the most common bacterias.

The study is published in the May issue of the Journal of Cataract & Refractive Surgery.