IS THE SUTURELESS CATARACT INCISION A VALVE FOR BACTERIAL INOCULATION

Many cataract surgeons perform sutureless surgery to decrease operatin g time, postoperative astigmatism, and healing time. Anecdotal case re ports of postoperative endophthalmitis after sutureless surgery prompt ed our investigation of this type of wound closure and its possible re lationship to an increased incidence of infection. This in vitro study addressed the question: Is sutureless more likely than sutured catara ct surgery to provide a route for inoculation of microbial organisms i nto the eye? Twenty-eight human eyes obtained postmortem were randomly divided into 14 pairs and successively incubated for 90, 150, 210, an d 270 minutes each in a suspension of Staphylococcus epidermidis in ph ysiologic media. Cultured aqueous aspirates yielded no significant dif ferences between sutured and unsutured eyes in colony counts at any ti me interval, This suggests that both sutured and unsutured wounds resi st bacterial ingrowth equally and that a properly constructed unsuture d wound is not a significant valve for bacterial inoculation in an eye pressurized to physiological conditions.