Ta Christopher N, Egbert Peter R, Singh Kuldev, Blumenkranz Mark S, de Kaspar Herminia Miño
Department of Ophthalmology, School of Medicine, Stanford University, Stanford, California 94304, USA.
Am J Ophthalmol. 2004 Apr;137(4):662-7. doi: 10.1016/j.ajo.2003.11.057.
To determine aqueous contamination rate in anterior segment intraocular surgery using two different techniques of obtaining aqueous fluid and to assess whether a 3-day application of topical 0.3% ofloxacin reduces this contamination rate compared with a 1-hour application.
Randomized clinical trial.
One hundred and thirty-three eyes of 130 patients undergoing anterior segment intraocular surgery were randomized to either control (64 eyes received topical ofloxacin 1 hour before surgery) or study groups (69 eyes received topical ofloxacin four times a day for 3 days before surgery in addition to 1 hour preoperatively). Eyes in both groups received a periorbital iodine scrub and two drops of topical 5% iodine. Aqueous fluid was obtained at the beginning and conclusion of surgery using a cannula passed through a paracentesis or a needle passed through clear cornea. The aqueous, cannula, and needles were inoculated in blood culture media broth and bacterial growth was identified.
Overall, eight of 89 aqueous samples (9%) obtained using a cannula at the beginning of surgery were culture-positive. Similarly, six of 41 aqueous samples (15%) obtained through a needle through clear cornea at the beginning of surgery showed contamination. At the conclusion of surgery, nine of 112 samples (8%) showed positive cultures. There was no difference in the aqueous contamination rates between the control and study groups.
Despite the use of a needle to obtain aqueous fluid at the beginning of surgery before creating a paracentesis, the aqueous contamination rate remained higher than that found at the conclusion of surgery. A 3-day application of topical ofloxacin before surgery did not reduce the anterior chamber aqueous contamination rate relative to a 1-hour application.
采用两种不同获取房水的技术，确定眼前节眼内手术中的房水污染率，并评估术前3天局部应用0.3%氧氟沙星与术前1小时应用相比是否能降低这种污染率。
随机临床试验。
130例接受眼前节眼内手术的患者的133只眼被随机分为对照组（64只眼在手术前1小时接受局部氧氟沙星治疗）或研究组（69只眼在手术前除术前1小时外，每天4次局部应用氧氟沙星，共3天）。两组的眼睛均接受眶周碘擦洗和两滴局部5%碘。在手术开始和结束时，使用通过前房穿刺的套管或通过透明角膜的针头获取房水。将房水、套管和针头接种于血培养肉汤中，并鉴定细菌生长情况。
总体而言，手术开始时使用套管获取的89份房水样本中有8份（9%）培养呈阳性。同样，手术开始时通过透明角膜的针头获取的41份房水样本中有6份（15%）显示污染。手术结束时，112份样本中有9份（8%）培养呈阳性。对照组和研究组之间的房水污染率没有差异。
尽管在进行前房穿刺前的手术开始时使用针头获取房水，但房水污染率仍高于手术结束时的污染率。术前3天局部应用氧氟沙星相对于术前1小时应用并未降低前房房水污染率。
