Changes in bacterial strains before and after cataract surgery.

PURPOSE

To investigate the rate of contamination of conjunctival smears and anterior chamber aspirates at the conclusion of cataract surgery, and the relation between the types of bacterial strain in the conjunctival sac and anterior chamber at the conclusion of surgery and in preoperative samples from the conjunctival sac of the same eye.

METHODS

The bacterial strains in conjunctival smears 1 week preoperatively and in conjunctival smears and anterior chamber aspirates at the conclusion of surgery from 58 consecutive eyes of 48 patients were examined. The patients underwent cataract surgery by phacoemulsification and aspiration followed by intraocular lens (IOL) implantation. All surgeries were broadcast simultaneously by closed-circuit television to the patients' families who were in a separate waiting room.

RESULTS

At the conclusion of surgery, six eyes (10.3%) were contaminated: one anterior chamber aspirate (1.7%) and five conjunctival smears (8.6%). Only two (33%) of the six contaminated eyes at the conclusion of surgery had the same bacterial strain as the preoperative conjunctival smears.

CONCLUSION

The percentage of culture-positive anterior chamber aspirates at the conclusion of phacoemulsification surgery and intraocular lens implantation was only 1.7%, despite a concurrent televised broadcast accompanied by an intraoperative microphone-transmitted explanation by the surgeon. Sixty-seven percent of the bacterial strains at the conclusion of surgery did not match those found preoperatively in the same eye.