Pg. Montan et al., Preoperative gentamicin eye drops and chlorhexidine solution in cataract surgery. Experimental and clinical results, EUR J OPTHA, 10(4), 2000, pp. 286-292
PURPOSE. 1) To evaluate the effects on the conjunctival flora of gentamicin
ophthalmic eye drops 0.3%, given four times in 45 minutes, and a conjuncti
val rinse with 10 ml chlorhexidine 0.05% solution. 2) To investigate retros
pectively the rate of endophthalmitis after cataract operations when these
antimicrobials were applied preoperatively.
METHODS. Seventy-six patients undergoing standard phacoemulsification opera
tions were enrolled in the experimental part of the study. Cultures were ta
ken preoperatively, 5 minutes after prophylaxis with either chlorhexidine o
r gentamicin. To assess the combined effects of chlorhexidine and gentamici
n, cultures were taken after the cataract operation. Hospital charts were r
eviewed for cases of endophthalmitis in 1994 and 1995, when this prophylact
ic protocol was used at the St Erik's cataract surgery department.
RESULTS. The conjunctival microflora was significantly suppressed by chlorh
exidine rinsing alone (p = 0.001), while no other significant anti-bacteria
l effects were observed with the experimental prophylaxis. The endophthalmi
tis rate was 32/12. 806 operations (0.25%).
CONCLUSIONS. Topical rinsing with chlorhexidine solution suppresses conjunc
tival flora in the short term. Combined topical chlorhexidine and gentamici
n prophylaxis does not eliminate postoperative endophthalmitis caused by gr
am-positive bacteria.