Antibiotic prophylaxis, surveillance may reduce risk of postoperative endophthalmitis

Antibiotic prophylaxis and topical povidone-iodine can reduce the risk of endophthalmitis after phacoemulsification, a study found.

“It is generally known that prophylactic measures cannot eliminate all commensal flora and that bacterial count is correlated to infection risks,” the study authors said. “Therefore, surveillance of residual microbiota and evaluation of their antibiotic susceptibility can drive prophylactic and therapeutic designs.”

The prospective study included 119 patients with a mean age of 74.8 years.

Patients received 5 mg/mL levofloxacin starting the day before surgery and topical 5% povidone-iodine drops starting 30 minutes before surgery.

Postoperatively, samples of drainage liquids were collected from drainage bags and peristaltic pump cassettes of the phacoemulsification machine; 238 samples were collected. Investigators searched for aerobic bacteria, anaerobic bacteria and fungi.

Study results showed growth of at least one microbial species in 75 patients (31.5%). There was at least one positive intraoperative solution in 66 patients (55.5%).

Drainage bags showed a significantly higher percentage of positive cultures than the peristaltic pump cassettes (P < .001).

Investigators identified a total of 111 microbial strains, 82 of which were gram-positive bacteria, 20 were fungi and nine were gram-negative bacteria.

Data showed no significant association between microbial isolation and risk factors. No postsurgical infective complications were identified during follow-up, the authors said.