Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kochi, Japan.
Science Research Center, Kochi University, Kochi, Japan.
Transl Vis Sci Technol. 2022 Apr 1;11(4):2. doi: 10.1167/tvst.11.4.2.
Post-cataract surgery bacterial endophthalmitis is a serious postoperative complication, and Enterococcus spp.-induced endophthalmitis reportedly has a particularly poor visual prognosis. This study aimed to demonstrate the prophylactic effect of postoperative intracameral phage administration in Enterococcus faecalis-induced endophthalmitis after cataract surgery in rabbits.
Endophthalmitis was induced in rabbits by injecting E. faecalis into the anterior chamber just after lensectomy while simultaneously administering either phage phiEF24C-P2 or vehicle. Retinal function was evaluated using electroretinography. The number of viable bacteria and myeloperoxidase (MPO) activity in the eye and histopathologic examinations were analyzed 48 hours after infection.
In the vehicle-treated group, retinal function at 24 hours after infection was impaired, and the number of viable bacteria and MPO activity in the eye increased 48 hours later. In the phage-administered group, retinal function was maintained; the number of viable bacteria and MPO activity were significantly suppressed. Histopathologic examinations showed disruption of the retinal layers and the presence of numerous E. faecalis in the lens capsule and vitreous cavity in vehicle-treated eyes. In contrast, retinal structures were intact, and no E. faecalis staining was observed in phage-treated eyes. No retinal dysfunction was observed in the group that received phage only without lensectomy; almost no phage was detected in the eyes after 14 days of treatment.
Phage administration in the anterior chamber did not cause retinal dysfunction and suppressed postoperative endophthalmitis in rabbits.
In vivo results of intracameral phage administration suggest that phages are a promising prophylactic candidate for postoperative endophthalmitis.
白内障手术后细菌性眼内炎是一种严重的术后并发症，据报道，肠球菌属引起的眼内炎预后特别差。本研究旨在证明在白内障手术后兔眼内注射肠球菌时，术后前房噬菌体给药的预防效果。
通过在晶状体切除后立即将肠球菌注入前房，在兔眼内诱导眼内炎，同时给予噬菌体 phiEF24C-P2 或载体。通过视网膜电图评估视网膜功能。感染后 48 小时分析眼内活菌数和髓过氧化物酶（MPO）活性以及组织病理学检查。
在载体处理组，感染后 24 小时视网膜功能受损，48 小时后眼内活菌数和 MPO 活性增加。在噬菌体给药组，视网膜功能得到维持；眼内活菌数和 MPO 活性均受到显著抑制。组织病理学检查显示，在载体处理的眼中，视网膜层被破坏，晶状体囊和玻璃体中有大量肠球菌。相比之下，在噬菌体处理的眼中，视网膜结构完整，未见肠球菌染色。仅接受噬菌体而不接受晶状体切除术的组未观察到视网膜功能障碍；治疗 14 天后，眼睛中几乎检测不到噬菌体。
前房内噬菌体给药不会引起视网膜功能障碍，并抑制兔眼术后眼内炎。
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