BACTERIAL-CONTAMINATION DURING EXTRACAPSULAR CATARACT-EXTRACTION - PROSPECTIVE-STUDY ON 200 CONSECUTIVE PATIENTS

Postoperative endophthalmitis remains one of the most devastating comp lications of eye surgery. In recent years infections with so called 'n onpathogenic' organisms like Propionibncterium acnes or coagulase-nega tive staphylococci have gained in importance. 200 patients were includ ed in this study, from whom preoperative smears of the conjunctiva and intraoperative aspirates of the anterior chamber (at the start and at the end of the operation) had been taken. All samples were investigat ed for aerobe and anaerobe microorganisms and fungi. 75% of the preope rative smears had been contaminated, with coagulase-negative staphyloc occi the most commonly isolated bacteria. But, in addition, 28% of the patients had culture-positive anterior chamber aspirates, also with c oagulase-negative staphylococci as the most frequent organisms. In all cases inoculum sizes were extremly small (10-20 c.f.u./ml). Probably because of this small inoculum, but also due to the bacteriocidal qual ities of the acqueous humor and the integrity of the posterior capsule sac, in no case had postoperative endophthalmitis developed. For the first time, our study tried to correlate the contamination of the ante rior chamber aspirate to the used operation technique: first results s how that the contamination of the aqueous humor is significantly lower (p < 0.03) if the cataract extraction is performed by phacoemulsifica tion than if done without.