Td. Manners et al., HEPARINIZED INTRAOCULAR INFUSION AND BACTERIAL-CONTAMINATION IN CATARACT-SURGERY, British journal of ophthalmology, 81(11), 1997, pp. 949-952
y Background/aims-Heparin in solution reduces bacterial adhesion to in
traocular lenses and a lower incidence of postoperative endophthalmiti
s has been reported with the use of heparin coated lenses. The safety
of adding low molecular weight heparin to the infusion fluid during ro
utine cataract surgery was investigated. Any direct antibacterial effe
ct was looked for by culturing anterior chamber fluid samples taken at
the completion of surgery. Methods-A randomised, double blind, contro
lled study of 111 patients undergoing routine cataract surgery. Low mo
lecular weight heparin at a concentration of 5 IU/ml was added to the
infusion fluid in the trial patients. Samples from the anterior chambe
r taken at completion of surgery were cultured. Twenty nine samples of
sterile infusion fluid were also cultured as further controls. Result
s-No complications were found in either group, and no difference in ob
served postoperative inflammation in each group. In the heparinised gr
oup (n=55) bacterial contamination was found in 31% of samples, compar
ed with 27% in the no heparin group (n=56) (no significant difference)
. Conclusions-There appears to be no direct antibacterial effect of he
parin, and other possible mechanisms of action are discussed. Heparin
avoids many of the drawbacks of traditional antibiotic prophylaxis and
may have the potential to be a safe and effective addition to endopht
halmitis prevention.