Study Of Antibiotics And Conjunctival Sac Wash Before Cataract Surgery

Introduction Cataract is the main causes of blindness in China, surgery is the only effective measurement of curing cataract. Bacterial endophthalmitis is the serious complication of cataract after an operation, once occurred, it will not only take badly effect on visual function, but also lead to disastrous consequences to sufferers. Thus the prevention of bacterial endophthalimitis after an operation is a vital step of clinic jobs. Reports in and outside China have confirmed that conjunctival sac is the mainly pathogenic germs of bacterial endophthalmits, it's critical for the conjunctival preparation without bacterial before cataract operation, to use antibiotics and conjunctival sac wash is commonly protective measurement nowadays. To understand bacterial kinds and their drug sensitivity before conjunctiva operation of cataract will do great help to drug-used and earlier clinic treatment. There are thousands of different reports on wash effect of using antibiotics and conjunctival sac wash.Thereby it will be so all-important value of reference to find a way of using antibiotics reasonably and conjunctival sac wash effectively in clinic practice. Objective To understand bacterial structure of cataract sufferer before operation by collecting conjunctival specimen as germculture. To guide clinic prescription order by seeking after the effect of using 2 kinds of antibiotics and 3 kinds of conjunctival sac wash before cataract operation. To observe the pollution of anterior chamber by taking out anterior chamber fluid as germculture.Methods Firstly, collecting conjunctival sac specimen from eye 201 of cataract sufferers on which scheduled operation will start, secondly, randomly dividing the sufferers into 2 groups, separately dripping eyes before operation with levofloxacin and tobramycin for 3 days, 4 times per day, collecting conjunctival sac specimen after dripping as germiculture.Thirdly,dividing the sufferers into 3 groups and separately washing conjunctival sac with normal saline, gentamicin and PloyvinylPyrolidone -iodine(PVP-I) before operation disinfection, collecting conjunctival sac specimen before and after washing as germiculture, making germiculture on anterior chamber fluid when the operation is over and collecting conjunctival sac specimen one day after the operation as germiculture.Results 113 germiculture specimens among 201 cases appeared positive before cataract operation, the ratio is 56.2%, the bacterial is mainly composed of gram-positive bacterial (91.1%), and among them are staphylococcus epidemidis (47.8%) and golden staphylococcus (19.5%).The germiculture positive ratio of using levofloxacin pre-and-post before cataract operation appeared 56.0% and 33.0% separately; the germiculture positive ratio of using tobramycin pre-and-post before cataract operation appeared 56.4% and 34.7%, there are obvious differences after using antibiotics (P<0.05), but there is no obvious difference among groups. The germiculture positive ratio of conjunctival sac wash pre-and-post for Group I which used normal saline,gentamicin and PVP-I before operation is 34.4% and 12.5%, 29.4% and 8.8%, 35.3%and 0% separately, and there's obvious difference (P<0.05) in statistics, this reflects the good effect of washing; Group C has better effect than Group A or Group B. For Group II, the germiculture positive ratio of conjunctival sac wash pre-and-post is 37.5% and 15.6%, 32.4% and 8.8%, 34.3% and 0% separately, and there's obvious difference (P<0.05) in statistics, this reflects the good effect of washing; Group C has better effect than Group A or Group B.Germiculture on anterior chamber fluid when 72 eyes using phacoemulsification appeared negative. Germiculture on conjunctival sac among 14 eyes one day after the operation appeared positive (7.0%), among them 5 eyes from Group I (5.0%), 9 eyes from Group II (8.9%).Conclusion The conjunctival sac bacterial before cataract operation is mainly composed of gram-positive bacterial; among them are staphylococcus epidemidis and golden staphylococcus. Levofloxacin and tobramycin are effective antibiotics to eliminate conjunctival sac bacterial before cataract operation, normal saline, gentamicin and PVP-I can be used to wash conjunctival sac before cataract operation, but PVP-I has better effect than the other 2 medicines. The sufferers use antibiotic eyedrops to eliminate conjunctival sac bacterial before operation, this will keep conjunctival sac in aseptic condition, aseptic operation should be strictly carried out during the operation, antibiotics will be used after operation to prevent occurrence of endophthalmitis.