The role of intraocular lenses in anterior chamber contamination during cataract surgery

Abstract

IOLs are apparently potential vehicles for introduction of intraocular bacterial contamination. Instillation of povidone-iodine 4% into the cul-de-sac reduces the risk of bacterial inoculum. Vancomycin is the most effective single agent against intraocular contamination. In order to reduce potential intraocular contamination it is advisable to avoid contact between the IOL and ocular tissues.

Corneal interface contamination during laser in situ keratomileusis

“…As in other studies of contamination during intraocular surgery, [9][10][11][12] S epidermidis was the most common organism (87.7%) isolated. This is expected because it is a normal inhabitant of the eyelids, eyelashes, and conjunctiva 11 and it is believed that bacteria that cause postoperative complications originate from the eyelids and conjunctiva.…”

A model for the management of an atypical endophthalmitis outbreak

“…The incidence, risk factors, prophylaxis, and management of POE have been widely reported in the ophthalmic literature. [1][2][3][4][5][6]22,23 However, the multidisciplinary process involved, from the point of determining what constitutes an outbreak, to investigating the cause of the outbreak and subsequent recommendations and changes in practice is less well documented. None of the members of our ophthalmic team had had any prior experience in Eye dealing with a POE outbreak and our aim is to share the lessons learnt.…”

“…Most cases of POE are due to bacteria entering the eye at the time of surgery by means of surgical instruments, the irrigation fluid, or by contamination of the intraocular lens implant (IOL). [19][20][21][22] The incidence of positive cultures has been reported as 56% in the BOSU survey. 6 In many cases, the organisms involved are thought to originate from the periocular flora.…”

Is it time for a new attitude to "simultaneous" bilateral cataract surgery?

“…It has been established by DNA analysis techniques that the micro-organisms causing endophthalmitis are commonly the patients' own commensal bacterial flora 30. The pooled data from anterior chamber contamination studies do not seem to relate to the endophthalmitis rate,37 38 despite culturing an organism from 20–29% of anterior chambers there were no clinical cases of endophthalmitis in 510 cases studied 3640-42Preoperative antibiotics were not used in any of these studies, which suggests that an otherwise healthy eye can handle a small inoculum of bacteria (all of these studies excluded patients with ocular surface diseases, who might be expected to have different bacterial profiles and be at higher risk of endophthalmitis).…”