Peroperative microbial contamination of anterior chamber aspirates during extracapsular cataract extraction and phacoemulsification
a West Of
England Eye Unit, b Public Health
Laboratories, Royal Devon and Exeter Hospital, Exeter, Devon, EX2 5DW
Correspondence to: Mr B Beigi, Adnexal Unit, Moorfields Eye Hospital, City Road, London EC1V 2PD.
Accepted for publication 4 June 1997
BACKGROUND
The normal conjunctival flora is one of
the main sources of intraocular contamination during cataract surgery.
The theory that the positive anterior chamber (AC) pressure during
phacoemulsification (phaco), and the smaller wound utilised, might
reduce the rate of contamination was studied.
METHODSThe peroperative AC aspirates of 210 consecutive patients undergoing cataract surgery were assessed. In
group 1, 100 patients underwent a standard extracapsular cataract
extraction (ECCE). In group 2, 110 patients underwent
phacoemulsification of the crystalline lens through a scleral tunnel.
AC aspirates from the Simcoe irrigation/aspiration cannula (group 1)
and phaco probe (group 2) were collected and microbiological studies
performed after direct and enrichment cultures.
RESULTSThere were 29 (29%) positives in the ECCE
group compared with 22 (20%) positive cultures from AC aspirates in
the phaco group. Coagulase negative staphylococcus (CNS) was the
commonest contaminant in both groups.
CONCLUSIONAlthough there was a higher rate of AC
contamination during ECCE, the difference was not statistically
significant (p> 0.10, 
2=2.31).
© 1997 by British Journal of Ophthalmology
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