Endophthalmitis following extracapsular cataract surgery: a review of 32 cases.

Heaven, C J; Mann, Preeti; Boase, D.L.

doi:10.1136/bjo.76.7.419

Cited by 59 publications

(21 citation statements)

References 27 publications

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“…Heaven et al 46 the 12 cases with negative culture. These results indicate that infectious PE could be more frequent in old people.…”

Section: Discussionmentioning

confidence: 99%

Influence of age on conjunctival bacteria of patients undergoing cataract surgery

Rubio

2005

Eye

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Aim To ascertain the effect of elderly in the conjunctival bacteria frequency of patients undergoing cataract extraction. Methods A retrospective case series study of 4432 consecutive patients who underwent cataract surgery, without excluding any of them for having pre-existing diseases. Their preoperative conjunctival culture were performed over a 3-year period (1994)(1995)(1996). Bacteria were grouped in nine categories and patients were divided into seven groups, according to age; comparisons between groups were made by means of the v 2 test, and the Mantel-Haenszel test to analyse age as a confounder, using SPSS program, version 12. Results Patients aged over 74 years accounted for 41.4%; women predominated among this group (61.4%), but not in the patients younger than 75 (47.7%); In the whole sample women accounted for 53.4%. Patients aged 75-96 years had a greater frequency of: Corynebacteria, Staphylococcus aureus, Streptococcus sp. (except Streptococcus pneumoniae), Gram-negative cocci and Gramnegative rods (except Haemophilus sp.) and 'other bacteria' categories than those aged 3-74 years. Different bacteria frequency in both sexes produced a confounding effect in the comparison between age-groups. Men had more Staphylococci coagulase (-), S. pneumoniae and Gram-negative rods than women. Conclusions Elderly patients awaiting cataract surgery had more conjunctival bacteria than those younger than 75 years, except Staphylococcus coagulase negative, S. pneumoniae and Haemophilus sp. At any age, men had more bacteria than women. These increments of frequencies could increase the risk of intraocular surgery contamination.

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“…Heaven et al 46 the 12 cases with negative culture. These results indicate that infectious PE could be more frequent in old people.…”

Section: Discussionmentioning

confidence: 99%

Influence of age on conjunctival bacteria of patients undergoing cataract surgery

Rubio

2005

Eye

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“…S. epidermidis has been found to be the most frequent organism grown in endophthalmitis after cataract surgery [7, 11, 12, 13, 14]. Gallenga et al [15]in their in vitro study demonstrated a significant increase in S. epidermidis growth in different dilutions of viscoelastic substances containing sodium hyaluronate.…”

Section: Discussionmentioning

confidence: 99%

In vitro Viability of External Eye Microbial Flora in Hydroxy-Propyl-Methylcellulose

et al. 1999

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The aim of this study was to verify the in vitro influence of various dilutions of a viscoelastic substance containing 2% hydroxy-propyl-methylcellulose (HPMC) on the viability of some microbial strains representative of the normal flora of the external eye. Pure reference strain cultures of Candida albicans, Pseudomonas aeruginosa, Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis and a fresh clinical isolate of Proteus mirabilis were selected for this study. Serial twofold dilutions of 2% HPMC, prepared so as to obtain a final concentration ranging from 50 to 0.78% of the product in sterile saline solution (0.85% NaCl), were taken out with a pipette that delivered 1.0 ml per tube. One hundred microliters of the abovementioned microbial inocula, used for the evaluation of the positive control of the test organism, were dispensed into each tube. After 24 h of incubation, 100 μl of samples were taken from each tube and plated into the specific medium for the growth of the test organism. After 24–48 h of incubation, these agar plates were examined and the colony-forming-unit count of each test organism was compared to the corresponding total colony count, acting as a positive control, in order to determine the quantitative variation of the test organism grown in the presence of the viscoelastic compounds. C. albicans and P. aeruginosa showed a statistically significant increase in growth with HPMC dilutions varying from 1:2 to 1:16. P. acnes and P. mirabilis growth was significantly reduced by all dilutions except for the 1:128 one. S. epidermidis growth was also significantly reduced in the presence of HPMC dilutions varying from 1:2 to 1:64. S. aureus growth was not significantly influenced. The viability of P. aeruginosa in HPMC dilutions needs to be carefully considered because of the ability of this organism to induce endophthalmitis, and the possibility that during cataract surgery, a small amount of HPMC may be left in the eye, trapped behind the intraocular lens optic.

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“…S. epidermidis has been found to be the most frequent organism grown in endophthalmitis after cataract surgery [3, 4, 5, 6, 7]. A scanning-electron-microscopy study by Jansen et al [12] showed massive colonization of the lens loop by S. epidermidis in a case of late-onset endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

“…Among them, Staphylococcus epidermidis is the most frequent species isolated from the conjunctiva and lids in both healthy and infected patients [2], and it is the most common organism identified in endophthalmitis following cataract surgery [3, 4, 5, 6, 7, 8]. …”

Section: Introductionmentioning

confidence: 99%

In vitro Staphylococcus epidermidis Growth in Some Viscoelastic Substances Containing Sodium Hyaluronate

et al. 1998

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The aim of our study was to verify the in vitro growth of Staphylococcus epidermidis in various dilutions of some viscoelastic substances containing hyaluronic acid (Healon® and Healon GV, IAL®, Biolon^TM). Serial twofold dilutions of each sterile viscoelastic substance, prepared so as to obtain a final concentration ranging from 50 to 0.78% of the product in sterile saline solution (0.85% NaCl), were taken out with a pipette that delivered 1.0 ml/tube. One hundred microliters of the S. epidermidis inocula, used for the evaluation of the positive control of the test organism, was dispensed into each tube. After 24 h of aerobic incubation at 37 °C, 100 μl of sample was taken out from each tube and plated into the specific medium for the growth of the test organism. After 24 h of incubation at 37 °C, these agar plates were examined and the colony-forming unit count of the test organism was compared to the corresponding total colony count, acting as a positive control, in order to determine the quantitative variation of the test organism grown in the presence of the viscoelastic compounds. For the lowest dilutions (from 1: 2 to 1: 8) statistically significant bacterial growth was detected in all tested viscoelastic substances. For the highest dilutions (1: 64 and 1: 128) Biolon and Healon GV showed a significant inhibition of S. epidermidis growth. A significant inhibition was also observed in the highest dilution (1: 128) of Healon. In every dilution of IAL a statistically significant increase in bacterial growth was observed. It remains to be carefully considered whether S. epidermidis, accidentally penetrating the eye via the intraocular lens, could find a culture medium in a small amount of sodium hyaluronate left in the capsular bag behind the optic.

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Endophthalmitis following extracapsular cataract surgery: a review of 32 cases.

Abstract: Thirty two cases of endophthalmitis following extracapsular cataract surgery that had occurred within our department and had undergone intraocular diagnostic tap between

Cited by 59 publications

References 27 publications

Influence of age on conjunctival bacteria of patients undergoing cataract surgery

Influence of age on conjunctival bacteria of patients undergoing cataract surgery

In vitro Viability of External Eye Microbial Flora in Hydroxy-Propyl-Methylcellulose

In vitro Staphylococcus epidermidis Growth in Some Viscoelastic Substances Containing Sodium Hyaluronate

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