Department of Ophthalmology, The Fourth People's Hospital of Shenyang, Shenyang Eye Research Institute, Key Laboratory of Ophthalmology of Shenyang, China.
Department of Ophthalmology, The Fourth People's Hospital of Shenyang, Shenyang Eye Research Institute, Key Laboratory of Ophthalmology of Shenyang, China; Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
Ocul Surf. 2018 Jan;16(1):70-76. doi: 10.1016/j.jtos.2017.09.001. Epub 2017 Sep 7.
To investigate the bacterial profile in the conjunctiva and meibomian glands in patients before penetrating ocular surgeries, and to compare the anti-bacterial efficacy of 0.5% levofloxacin and its combination with meibomian gland massage.
Hospital-based, case-control study.
Two hundred and twenty-six eyes from 226 patients with non-infective ocular diseases and scheduled for penetrating ocular surgeries.
Tested eyes were administered topical 0.5% levofloxacin (4 times daily) for 2 days. Among them, 91 eyes received meibomian gland massage before levofloxacin application. Samples from the conjunctival sac and meibomian glands were collected for aerobic and anaerobic cultures.
Culture-positivity and bacterial strains.
Before treatment, aerobes and anaerobes were cultured from 38.5% and 11.0% of the conjunctival samples respectively, compared with 38.5% and 8.8% in the meibomian secretions respectively. Staphylococcus epidermidis and Propionibacterium acnes were the commonest isolated aerobe and anaerobe. Two-day application of levofloxacin reduced aerobic growth to 29.6% in the conjunctiva and 19.3% in the meibomian glands. It had no effect on the anaerobes in these regions (13.3% in the conjunctiva and 10.4% in the meibomian glands). Combined levofloxacin with meibomian gland massage further reduced aerobic growth to 19.8% in the conjunctiva and 11.0% in the meibomian glands. It also drastically decreased anaerobic growth in the meibomian glands (1.1%).
Meibomian glands carrying considerable bacteria should be considered as a potential source of contamination in ocular surgery. Meibomian gland massage shows additional anti-bacterial effects to topical levofloxacin and could be recommended as a complementary preoperative prophylaxis.
研究穿透性眼部手术前患者结膜囊和睑板腺中的细菌谱，并比较 0.5%左氧氟沙星及其联合睑板腺按摩的抗菌效果。
基于医院的病例对照研究。
226 例非感染性眼病患者的 226 只眼，拟行穿透性眼部手术。
受试眼局部滴注 0.5%左氧氟沙星（每日 4 次），连用 2 天。其中 91 只眼在滴注左氧氟沙星前接受睑板腺按摩。采集结膜囊和睑板腺样本进行需氧和厌氧菌培养。
培养阳性率和细菌株。
治疗前，结膜标本分别培养出需氧菌和厌氧菌的比例为 38.5%和 11.0%，睑板腺分泌物中分别为 38.5%和 8.8%。表皮葡萄球菌和痤疮丙酸杆菌是最常见的分离需氧菌和厌氧菌。左氧氟沙星连续应用 2 天，可使结膜中的需氧菌减少至 29.6%，睑板腺中的需氧菌减少至 19.3%。但对这些部位的厌氧菌无影响（结膜中为 13.3%，睑板腺中为 10.4%）。左氧氟沙星联合睑板腺按摩可使结膜中的需氧菌减少至 19.8%，睑板腺中的需氧菌减少至 11.0%。同时，还可显著减少睑板腺中的厌氧菌（1.1%）。
应将含有大量细菌的睑板腺视为眼部手术污染的潜在来源。睑板腺按摩除了具有局部滴注左氧氟沙星的抗菌作用外，还可作为一种补充性术前预防措施。
