| Objective: To observe the inhibitory effect of 0.5% povidone-iodine conjunctival sac flushing and eyelid margin cleaning on the preoperative ocular surface flora of cataract patients and the influence in corneal epithelial cells.It provides a theoretical basis for whether the eyelid margin cleaning should be standardized before cataract surgery.Method: A total of 84 cataract surgery patients(84 eyes)admitted to Chang Zhou Second People’s Hospital from August 2020 to January 2021 are randomly divided into conjunctival sac flushing group and eyelid margin cleansing group with 42 cases each group(42 eyes each,all non-surgical eyes).Bacterial culture of conjunctiva sac and eyelid margin were completed on the day of admission.All the surgical eyes receive levofloxacin eye drops 3 days before the operation.,meanwhile all non-surgical eyes are not handled.The conjunctival sac flushing group receive 0.5% povidone-iodine on the day of the operation for conjunctival sac flushing,and the eyelid margin cleaning group use clean cotton pads(including :1,3-propanediol,butanediol,Surfactants: aloe vera juice,polyurethane biguanidine etc.)to clean the eyelid margins.The bacteria culture and identification are completed after preventive treatment in conjunctival sac group and eyelid margins group.The occurrence of corneal epithelial injury 1 day after operation and ocular adverse reaction score are counted and compared between two groups.The results were statistically analyzed between two groups.Results:After excluding the influence of gender,age and place of origin,it is concluded that: 1.There is no significant difference in positive rate of bacterial culture in conjunctival sac and eyelid margin between the conjunctival sac flushing group and the eyelid margin cleaning group before treatment.The positive rate of bacterial culture in contrast eyelid margin is higher than that in conjunctival sac.2.After taking antibacterial measures,conjunctival sac irrigation and eyelid margin cleaning can both inhibit the bacteria of eyelid margin and conjunctival sac.3.After finishing analysis of bacterial culture of eyelid margin,we can draw a conclusion that the bacteriostatic effect of eyelid margin cleaning group is better than that of conjunctival sac washing group,and the difference is statistically significant.4.After finishing analysis of bacterial culture of conjunctival sac,we can draw a conclusion that the bacteriostatic effect of conjunctival sac irrigation group is better than that of eyelid margin cleaning group,and the difference is statistically significant.5.One day after Cataract phacoemulsification +intraocular lens implantation,the incidence of corneal epithelial injury and ocular discomfort in blepharoplasty group is lower than that in conjunctival sac irrigation group,and the difference is statistically significant.Conclusion: Preoperative 0.5% povidone-iodine conjunctival sac flushing and eyelid margin cleaning for clinical cataract patients are both have an inhibitory effect on the ocular surface flora.0.5% povidone-iodine conjunctival sac flushing has a stronger overall bacterial inhibitory effect in conjunctival sac.But it has a serious impact on corneal epithelium and the adverse reaction is relatively serious,meanwhile,it is also easy to cause patients’ eyes feeling discomfortable.At the same time,eyelid margin cleaning can also inhibit the bacteria.Though the bacteriostatic effect can not reach the level of conjunitival sac flushing,it has a slight impact on the corneal epithelium(almost can be ignored),and the adverse reactions are not serious.Therefore,in clinical practice,if the patient has corneal epithelial defect or dry eye disease and other disease are not resistant to conjunctival sac flushing,we can use eyelid margin cleaning instead of conjunctival sac irrigation to prevent postoperative infectious entophthalmia after cataract surgery to reduce postoperative discomfort and improve patients’ satisfaction with surgery. |
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