Cirugía de la cataratacómo lograr la mejor asepsia del campo quirúrgico

Abstract

Purpose: To evaluate the asepsia achieved with the use of 5% povidone iodine by determining the bacterial contamination of the anterior chamber fluid at the end of uneventful cataract surgery with IOL implantation. Two techniques are compared: ECCE and phacoemulsification. Material and methods: Eighty eyes (40 having ECCE and 40 phacoemulsification) participated in the study. Patients didn't receive any preoperative (topical or systemic) or intraoperative (infusion fluid) antibiotics. In every case immediate preoperative antisepsia of the periocular skin, eyelids and ocular surface was performed with the use of 5% povidone iodine. Samples were taken at the end of the surgery and immediately inoculated into blood culture bottles. Results: Three samples (3.75%) were positive: 2 in the ECCE and 1 in the phacoemulsification group. The bacteria isolated were Steptococcus mitis, Haemophilus parainfluenzae and Staphylococcus saprophyticus. No subsequent endophthalmitis developed in any patient. Conclusions: In cataract surgery, by just using topical antiseptics (5% povidone iodine) prior to surgery and by following rigorous aseptic measures, it is possible to reduce substantialy (3.75%) anterior chamber contamination.