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Surgical contamination of the anterior chamber during lens surgery
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Cataract phacoemulsification and intraocular lens implantation are routine surgical procedures is small animal practice. How high is the risk of intraoperative contamination of the anterior chamber with viable microorganisms and does it perhaps correspond with the patient´s extraocular and nasal cavity floras? Interesting questions, raised and answered in this brand-new article!
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The objective of this study was to determine the frequency of during cataract phacoemulsification and intraocular lens implantation, and to evaluate the relationship of contaminant microorganisms to patients` extraocular and nasal cavity floras. Also, the impact of various aspects of the patient history and phacoemulsification procedure on the incidence of positive postoperative anterior chamber cultures was investigated.
Twenty-two eyes from 13 dogs presented for elective cataract phacoemulsification and intraocular lens implantation were studied.
Preoperatively, microbiologic samples of the conjunctiva, eyelid margins, nares, and rostral nasal cavity were collected.
Postoperatively, anterior chamber fluid was aspirated.
Samples were submitted for aerobic/anaerobic bacteriologic culture and antimicrobial susceptibility, Mycoplasma culture, and fungal culture.
Anterior chamber aspirates collected at the conclusion of surgery were culture positive for at least one organism in 22.7% of eyes. Three aerobic bacteria and three fungi were isolated from the anterior chamber aspirates. Two fungi and one bacterium isolated from the anterior chamber were typed identically, and the bacterium had a similar antibiogram to organisms recovered from the patient`s conjunctiva and eyelid margin.
No statistically significant difference in contamination frequency was found for the investigated patient and surgical variables.
We conclude that intraoperative contamination of the anterior chamber with viable bacterial and fungal organisms is a common occurrence in canine patients undergoing cataract phacoemulsification and intraocular lens implantation, and the external ocular flora is a likely source of some of these contaminating microorganisms. This contamination is independent of the patient and surgical variables investigated.
Source: Ledbetter, Eric C., Millichamp, Nicholas J. & Dziezyc, Joan (2004): Microbial contamination of the anterior chamber during cataract phacoemulsification and intraocular lens implantation in dogs. In: Veterinary Ophthalmology 7 (5), 327-334.
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