Intraocular bacterial contamination during sutureless, small incision, single-port phacoemulsification

Purpose: To evaluate the incidence of anterior Chamber bacterial contaminat ion during no-stitch, 1-handed, small incision phacoemulsification. Setting: Little Company of Mary Hospital, Evergreen Park, Illinois, USA. Methods: This study comprised 53 eyes of 46 patients. Topical gentamicin su lfate was administered 1 hour preoperatively. After povidone-iodine cleansi ng solution and povidone-iodine paint (5% and 10%) were applied, the eyes w ere draped in a sterile manner. Aqueous fluid was aspirated upon entering t he anterior chamber and at the end of surgery; the specimens were cultured for up to 14 days. All eyes had no-stitch, 1-handed, small incision phacoem ulsification with implantation of a foldable acrylic posterior chamber intr aocular lens through a 3.5 mm scleral tunnel incision. Results: Three specimens (5.7%) aspirated on entry into the anterior chambe r were positive for microorganisms. Of the cultures obtained at the end of surgery, 4 (7.5%) were positive for microorganisms; All posterior lens caps ules were intact. The following organisms were cultured at the end of phaco emulsification: alpha -streptococci, micrococci, saprophytic mold, alpha -v iridans streptococci, coagulase-negative Staphylococcus species, and anaero bic positive cocci. No eye developed endophthalmitis. Conclusions: The incidence of anterior chamber bacterial contamination was low. Bacterial contamination of the anterior chamber occurred at the beginn ing and toward the end of phacoemulsification, Staphylococcus species was t he most common organism in the beginning, while Streptococcus species was t he most common at the end. Saprophytic mold was present only at the end. No eye developed endophthalmitis. J Cataract Refract Surg 2000; 26:1786-1791 (C) 2000 ASCRS and ESCRS.