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2008 OMIG, Abstract 7

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Three Different Preventive Methods for Endophthalmitis; Which is the Best?
S Kobayakawa1, A Tsuji2, T Tochikubo1.
Department of Ophthalmology, Toho University, Tokyo, Japan.
2 Department of Infection Control and Prevention, School of Nursing, Faculty of Medicine, Toho University, Tokyo, Japan.

Purpose: To compare the efficacy of three different preventive methods for postoperative endophthalmitis, eye drops, intracameral, and hydrophilic intraocular lenses (IOL), in a rabbit model.
Methods: E. faecalis strain, clinical isolate from endophthalmitis case, was used. Gatifloxacin (GFLX, BAK free) was used. The MIC for E.faecalis to GFLX was 0.5μg/ml. As eye drops method, GFLX 0.3% eyedrops were administered eight times every fifteen minutes, started at zero, two, four and six hours postinfection. As intracameral, two different concentrations GFLX (0.3% and 0.03%) were administered in the anterior chamber at the end of cataract surgery. As hydrophilic IOL (Bausch and Lomb, USA), IOLs were immersed in 2–3 ml of GFLX solution (0.5%) for 24 hr. Experimental E. faecalis endophthalmitis was induced at the end of cataract surgery with IOL implantation (silicone IOL or hydrophilic IOL, approximately 106 CFU/eye injections). The surgical eyes were enucleated at 24 hr postoperatively, bacterial population was then examined.
Results:The bacterial populations were no significant differences in GFLX 0.3% eye drop treatment groups (5.60-7.40 log10CFU/ml) and in the control group (6.47-6.82 log10CFU/ml) respectively. No bacteria in the surgical eyes were in using intracameral GFLX 0.3% and 0.03%. Also, the bacterial populations in eyes with an antibiotics-treated hydrophilic IOL were significantly smaller than in the control group (3.11 log10CFU/ml, p < 0.01).
Conclusions:In the case of experimental E. faecalis endophthalmitis, multiple administrations for GFLX 0.3% eyedrops were not effective. By contrast, intracameral and antibiotics-treated hydrophilic IOL showed remarkable preventive effect.

Disclosure code: N

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