From Miyata Eye Hospital (Ono, Nejima, Iwasaki, Mori, Noguchi, Yagi, Miyata), Miyakonojo, and the Kitasato Institute for Life Sciences (Hanaki), Kitasato University, Tokyo, Japan.
From Miyata Eye Hospital (Ono, Nejima, Iwasaki, Mori, Noguchi, Yagi, Miyata), Miyakonojo, and the Kitasato Institute for Life Sciences (Hanaki), Kitasato University, Tokyo, Japan.
J Cataract Refract Surg. 2017 Sep;43(9):1129-1134. doi: 10.1016/j.jcrs.2017.06.037.
To clarify the long-term effect of topical antibiotics on the ocular bacterial flora after cataract surgery.
Miyata Eye Hospital, Miyazaki, Japan.
Prospective case series.
Patients who had cataract surgery between November 2014 and January 2015 were included. Levofloxacin 1.5% was administered 4 times a day by topical instillation from 3 days before surgery to 1 month postoperatively. The conjunctival sacs of patients were scraped before the procedure and 0, 3, 6, 9, and 12 months after the last instillation. The samples were cultured, and minimum inhibitory concentrations (MICs) of levofloxacin for Staphylococcus epidermidis and Propionibacterium acnes were evaluated using mixed-effects models.
The study evaluated 50 patients. Diverse bacterial species, predominantly S epidermidis and P acnes, were isolated before the application of topical levofloxacin. Bacterial diversity was substantially reduced after the final topical levofloxacin application and subsequently increased after 3 months. However, the geometric mean levofloxacin MICs for S epidermidis isolates were still significantly higher at 0 months and 3 months than before treatment (P < .01 and P = .03, respectively) and reached pretreatment levels 6 months and 12 months after the last application. Propionibacterium acnes did not show significant changes in the geometric mean levofloxacin MIC over time.
The restoration of the bacterial flora required more than 6 months after cataract surgery and topical levofloxacin.
阐明白内障手术后局部应用抗生素对眼表细菌菌群的长期影响。
日本宫崎宫内田眼科医院。
前瞻性病例系列。
纳入 2014 年 11 月至 2015 年 1 月期间行白内障手术的患者。术前 3 天至术后 1 个月，每日 4 次局部滴左氧氟沙星 1.5%。术前及末次滴眼后 0、3、6、9 和 12 个月刮取患者结膜囊标本，进行培养，采用混合效应模型评估表皮葡萄球菌和痤疮丙酸杆菌对左氧氟沙星的最小抑菌浓度（MIC）。
该研究共评估了 50 例患者。在使用局部左氧氟沙星之前，分离出了多种细菌，主要为表皮葡萄球菌和痤疮丙酸杆菌。末次滴眼后，细菌多样性显著降低，3 个月后逐渐增加。然而，表皮葡萄球菌分离株的左氧氟沙星几何平均 MIC 在 0 个月和 3 个月时仍显著高于治疗前（P<0.01 和 P=0.03），末次滴眼后 6 个月和 12 个月时恢复至治疗前水平。痤疮丙酸杆菌的左氧氟沙星几何平均 MIC 随时间无显著变化。
白内障手术后和局部应用左氧氟沙星后，眼表细菌菌群的恢复需要 6 个月以上的时间。
