Does surgical technique influence cataract surgery contamination?

• Published in: European journal of ophthalmology Vol. 11; no. 1; pp. 31 - 36
• Main Authors: KOC, F, AKCAM, Z, KURUOGLU, S, ÖGE, I, GÜNAYDIN, M
• Format: Journal Article
• Language: English
• Published: Milano Wichtig 2001
• Subjects: Aqueous Humor - microbiology; Bacteria - isolation & purification; Biological and medical sciences; Cataract Extraction - adverse effects; Cataract Extraction - methods; Colony Count, Microbial; Conjunctiva - microbiology; Eye Infections, Bacterial - microbiology; Female; Humans; Intraoperative Complications - microbiology; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Medical sciences; Middle Aged; Polymethyl Methacrylate; Prospective Studies; Risk Factors; Silicone Elastomers; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Time Factors; Human; Cataract; Iatrogenic; Intraoperative; Uvea disease; Phacoemulsification; Extracapsular; Contamination; Infection; Eye disease; Lens disease; Treatment; Surgery; Bacteriosis; Complication; Lens; Extraction; Endophtalmitis; Anterior segment disease; Comparative study
• ISSN: 1120-6721; 1724-6016
• DOI: 10.1177/112067210101100107

To compare cataract surgery contamination rates in large-incision extracapsular cataract extraction (ECCE) and phacoemulsification (PE), we studied 65 cases prospectively.
Thirty-five cases were operated by large-incision ECCE (Group I) and 30 by PE (Group II). Conjunctival swab cultures were taken immediately before surgery and anterior chamber aspirate was taken for culture upon completion of surgery for each case.
Anterior chamber cultures were positive in 22.8% of the cases in group I and 23% in Group II. Frequencies of contamination in each group were no different (x2: 0.22, p>0.05). When the contaminations were evaluated in relation to operating time, prolongation of the operating time raised the contamination rate in Group I (p<0.05) but not in Group II (p>0.05). Silicone and PMMA intraocular lenses (IOL) were tested to see whether they had any additional risk of contamination. The frequencies of contaminated silicone IOL implanted cases (6/26) and contaminated PMMA IOL implanted cases (8/39) were similar (x2: 0.36, p>0. 05).
Although the architecture of the incision and irrigation dynamics provided an advantage to the PE technique as the operating time became longer, routine PE was not superior to classical ECCE with respect to contamination when performed in the same circumstances. Prolonging the operating time raised the contamination rate in classical ECCE.