HEPARINIZED INTRAOCULAR INFUSION AND BACTERIAL-CONTAMINATION IN CATARACT-SURGERY

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.