Chemical Preparation of the Eye in Ophthalmic Surgery

Apt, Leonard

doi:10.1001/archopht.1984.01040030584025

Cited by 188 publications

(35 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Antimicrobial agents applied locally usually provide higher drug levels on the surface of devices and the immediate vicinity than does systemic administration (1). Various approaches to local prophylaxis have been tried to prevent bacterial colonization, including antimicrobial irrigation of the surgical field (such as sterilizing the ocular surface with povidone-iodine before ophthalmic surgery [14]), placement of antimicrobial carriers (e.g., intraoperative insertion of antibiotic-treated prosthetic devices in orthopedics [15]), dipping implants into antimicrobial solutions (e.g., immersion of a heart valve prosthesis into antibiotic solution before implantation [16]), and coating surgical implants with antimicrobials (17). Among these methods, coating implants with antimicrobials provides the unique advantage of potentially delivering the antimicrobial drug in a controllable manner via conditioned biodegradation of chemical bonds that cross-link the implant surface with the antimicrobial drugs.…”

supporting

confidence: 42%

Effectiveness of Antimicrobial Peptide Immobilization for Preventing Perioperative Cornea Implant-Associated Bacterial Infection

Tan

Goh

Saraswathi

et al. 2014

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Titanium (Ti) is a promising candidate biomaterial for an artificial corneal skirt. Antimicrobial peptide (AMP) immobilization may improve the bactericidal effect of the Ti substrate. In this study, we tested the bactericidal efficacy of a functionalized Ti surface in a rabbit keratitis model. A corneal stromal pocket was created by a femtosecond laser. The Ti films were then inserted into the pocket, and Staphylococcus aureus or Pseudomonas aeruginosa was inoculated into the pocket above the implant films. The corneas with Ti-AMP implants were compared with the corneas implanted with unprotected Ti by slit lamp observation and anterior segment optical coherence tomography (AS-OCT). Inflammatory responses were evaluated by bacterium counting, hematoxylin-eosin staining, and immunostaining. There was a lower incidence and a lesser extent of infection on rabbit corneas with Ti-AMP implants than on those with unprotected Ti implants. The bactericidal effect of AMP against S. aureus was comparable to that of postoperative prophylactic antibiotic treatment; hence, SESB2V AMP bound to the Ti implant provided functional activity in vivo, but its efficacy was greater against S. aureus than against P. aeruginosa. This work suggests that SESB2V AMP can be successfully functionalized in a rabbit keratitis model to prevent perioperative corneal infection.

show abstract

supporting

confidence: 42%

Effectiveness of Antimicrobial Peptide Immobilization for Preventing Perioperative Cornea Implant-Associated Bacterial Infection

Tan

Goh

Saraswathi

et al. 2014

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Although the sources of contamination are multiple, the microbial population of the ocular surface is an important reservoir (8). Several different antiseptic agents are used for preoperative skin preparation in ocular surgery (1), but postoperative infection may be related more commonly to residual microflora from the conjunctiva rather than from the periocular skin (8).…”

supporting

confidence: 38%

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Hamill¹,

Osato²,

Wilhelmus³

1984

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Chlorhexidine gluconate is a bisguanide germicide currently available with 70% isopropanol (Hibistat, Hibitane) or a detergent (Hibiclens, Hibiscrub) for preoperative skin preparation. As these solvents are toxic to the cornea, we investigated the safety and efficacy of aqueous chlorhexidine solutions for ophthalmic use. Chlorhexidine in Tris-glycine buffer was evaluated for retardation of epithelial regeneration after experimental corneal abrasion in rabbits. Irrigant concentrations of 2.0 and 4.0% chlorhexidine significantly slowed the healing rate (0.546 and 0.076 mm/h, respectively) compared with saline controls (0.938 mm/h). Irrigant concentrations of .l% did not statistically delay healing (P > 0.4). In a separate group of animals, the right conjunctivae of pigmented rabbits were inoculated with Staphylococcus epidermidis (_107 organisms per eye) and irrigated with 40 ,lI of aqueous chlorhexidine in concentrations of 0.1, 0.5, and 1.0%; the left eyes were irrigated with saline or left untreated. Quantitative conjunctival cultures were obtained, and the total number of organisms recovered per eye was calculated. All chlorhexidine-treated eyes showed significant reduction in organisms compared with either untreated or saline-irrigated control eyes (P < 0.001). In vitro antimicrobial susceptibility testing demonstrated chlorhexidine in concentrations of 0.1 to 4% to be highly active against a variety of gram-positive and gram-negative bacterial pathogens by disk diffusion and broth diffusion assays.

show abstract

“…Consequently only antiseptic treatment of the transplant and aseptic treatment during preservation can minimize the microorganisms on the graft. In our eye bank, the donor globes were incubated in 3% Betaisodona, because PVP-iodine has bactericidal, virucidal and fungicidal properties [18, 19, 20, 21] and, in contrast to the use of antibiotics, there are no problems with resistances. PVP-iodine has been shown to induce an evident reduction of the microbial flora of corneas [4, 22, 23].…”

Section: Discussionmentioning

confidence: 45%

Microbiological Investigations to Validate the Preparation of Corneal Transplants

Duncker¹

1998

Ophthalmologica

View full text Add to dashboard Cite

The globe and cornea are colonized by microorganisms and cannot be removed as sterile products. Antiseptic measures and storage of the cornea in medium containing antibiotics lead to an obvious reduction of the microbial flora. Unfortunately there is the possibility of secondary microbial contamination during the preparation. Large amounts of bacteria or resistant bacteria can ruin attempts to reduce the microbial flora. To validate the whole process of preparation we investigated the contamination of removed globes, environment, materials, instruments and media for each sequence of operation and eliminated sources of contamination. Recommendations are given to ensure a virtually sterile product at the end of preparation.

show abstract

Chemical Preparation of the Eye in Ophthalmic Surgery

Cited by 188 publications

References 10 publications

Effectiveness of Antimicrobial Peptide Immobilization for Preventing Perioperative Cornea Implant-Associated Bacterial Infection

Effectiveness of Antimicrobial Peptide Immobilization for Preventing Perioperative Cornea Implant-Associated Bacterial Infection

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Microbiological Investigations to Validate the Preparation of Corneal Transplants

Contact Info

Product

Resources

About