Does surgical technique influence cataract surgery contamination?

PURPOSE. To compare cataract surgery contamination rates in large-incision extracapsular cataract extraction (ECCE) and phacoemulsification (PE), we s tudied 65 cases prospectively. METHODS. Thirty-five cases were operated by large-incision ECCE (Group I) a nd 30 by PE (Group II). Conjunctival swab cultures were taken immediately b efore surgery and anterior chamber aspirate was taken for culture upon comp letion of surgery for each case. RESULTS. Anterior chamber cultures were positive in 22.8% of the cases in g roup I and 23% in Group II. Frequencies of contamination in each group were no different (x(2): 0.22, p>0.05). When the contaminations were evaluated in relation to operating time, prolongation of the operating time raised th e contamination rate in Group I (p<0.05) but not in Group II (p>0.05). Sili cone and PMMA intraocular lenses (IOL) were tested to see whether they had any additional risk of contamination. The frequencies of contaminated silic one IOL implanted cases (6/26) and contaminated PMMA IOL implanted cases (8 /39) were similar (x(2): 0.36, p >0.05). CONCLUSIONS. Although the architecture of the incision and irrigation dynam ics provided an advantage to the PE technique as the operating time became longer, routine PE was not superior to classical ECCE with respect to conta mination when performed in the same circumstances. Prolonging the operating time raised the contamination rate in classical ECCE.