Comparison of 1‐day versus 1‐hour application of topical neomycin/polymyxin‐B before cataract surgery. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Li, Bing; de Kaspar, Herminia Miño; Haritoglou, Christos; Kook, Daniel; Kampik, Anselm; Sheng, Minjie; Nentwich, Martin M.
• Is Part Of: Journal of cataract and refractive surgery. Volume 41:Issue 4(2015)
• Publication Date: 2015-04
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2014.06.042
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose : To compare the efficacy of 2 prophylaxis regimens before cataract surgery using topical antibiotics (1 hour before surgery versus the day before), both with povidone–iodine, with regard to reducing the preoperative conjunctival bacterial load. Setting : Tertiary ophthalmic referral center, Munich, Germany. Design : Prospective comparative case series. Methods : Eyes were treated with topical antibiotics and their conjunctival sac flush irrigated using 10 mL of povidone–iodine 1.0%. All eyes were randomized to receive either 4 applications of topical 3500 IU/mL neomycin sulfate/6000 IU/mL polymyxin‐B sulfate within 1 hour preoperatively (Group 1) or on the day before surgery (Group 2). Conjunctival specimens were obtained at 4 timepoints: T 0 C untreated fellow eye (control), T 0 surgery eye (after antibiotic prophylaxis but before povidone–iodine irrigation), T 1 after povidone–iodine, and T 2 at the conclusion of surgery. All specimens were inoculated onto blood and chocolate–blood agar and into thioglycollate broth. Results : One hundred thirty‐three eyes of 133 consecutive patients were included (Group 1, 64 eyes; Group 2, 69 eyes). The antibiotic regimens were equally effective in reducing the aerobic and microaerophilic conjunctival flora (Group 1, P =.028; Group 2, P =.000), but had no significant effect on anaerobic bacteria (Group 1, P =.201; Group 2, P =.117). Flush irrigation of the conjunctival sac using 10.0 mL povidone–iodine 1.0% significantly decreased the conjunctival bacterial load in both groups. Conclusion : Topical neomycin/polymyxin‐B was equally effective in reducing the conjunctival bacterial load whether given 1 day or 1 hour before surgery. The greatest effect was achieved by irrigating the conjunctival sac using povidone–iodine. Financial Disclosure : No author has a financial or proprietary interest in any material or method mentioned.