Aims-The study was designed to investigate the bacterial flora of the operating field during routine cataract surgery and the source of intraocular lens contamination during the surgery. Methods-The normal flora of the external eye and fornices of 17 patients undergoing selective cataract surgery was determined preoperatively. Swabs taken from the eyelid surface and lashes showed coagulase negative staphylococci (CNS) Material and methods Seventeen patients, nine male and eight female and without an active infectious disease, were entered into the study. Their ages ranged from 22 to 82 (mean 75) years. Preoperatively, three cotton wool swabs moistened in sterile saline were used to sample the skin of the upper lid, the base of the lashes, and the lower fomix of each patient. This was performed in the ward.Ocular preparation in theatre included cleaning of eyelids and lashes with chlorhexidine acetate BP 0.02%, 1/5000 dilution.Lashes were not cut and no prophylactic topical or systemic antibiotics were used. Patients were draped with disposable 3M perforated ophthalmic sheet 1064, and an adhesive barrier (3M steridrape 2035) was used to keep the lashes away from the field of the surgery.Thirty four sterile PMMA IOLs were used in the operating theatre (none of the IOLs were irrigated before use). After draping each patient, the upper lid was pulled up and a sterile IOL was touched onto the upper bulbar conjunctiva using a sterile forceps (total 17). It was then placed in a sterile container and immediately transported to the laboratory.Peroperatively, a control lens was placed on the drape within 2-4 cm of the edge of the steridrape (total 17). It was left in this position for the duration of surgery, 20 to 40 (mean 30 minutes). It was then placed in a sterile container and immediately sent to the laboratory.Two settle plates, one containing Columbia agar with 7% horse blood and the other containing Lab M fastidious anaerobic agar with 7% horse blood and nalidixic acid, were exposed in the operating theatre in each instance to monitor airborne contamination.Swabs and IOLs were cultured without delay, onto Columbia blood agar plates containing 7% horse blood, and onto Lab M fastidious anaerobic agar plates (FAA) containing 7% horse blood and nalidixic acid as a selective agent. Lenses were then dropped into cooked meat medium which was incubated at 370C.

Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p < 0.02). Glycaemic was worse in TG compared to CON at 13, 26 and 35 weeks gestation, despite higher insulin doses. First trimester miscarriage rate did not differ between groups. Major congenital anomaly rate was 6.2% (1/16) compared to 3.2% in CON. This preliminary study has demonstrated that pregnant teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes.