gramicidin-a and Eye-Diseases

Povidone-iodine 5% solution decreases the incidence of postoperative endophthalmitis when used on the eye for preoperative preparation. We sought to determine whether it also minimized conjunctival bacterial flora immediately after surgery by preventing bacteria present on the surface of the eye from entering surgical wounds.. In 42 eyes of 40 patients, at the conclusion of surgery, on an alternating basis, each patient received either a drop of a broad-spectrum antibiotic solution (polymyxin B sulfate-neomycin sulfate-gramicidin) or a 5% povidone-iodine solution in the operated-on eye. Bacterial cultures were taken before and after surgery and 24 hours later. The 38 unoperated-on eyes in the unilateral cases served as control eyes.. Relative to the control group, povidone-iodine was effective in preventing an increase in the number of colony-forming units (P = .035), while the antibiotic was not. At 24 hours after surgery, the species count was lower in the eyes receiving povidone-iodine than in the antibiotic-treated eyes (P = .034) and was increased in the antibiotic group since the completion of surgery (P = .013), but was lower in the povidone-iodine and antibiotic groups than in the control eyes for both groups (P < .01).. Povidone-iodine 5% solution applied to the eye at the conclusion of surgery was more effective at minimizing the number of colony-forming units and species for the first postoperative day than was a broad-spectrum antibiotic. While not true for the antibiotic, the antimicrobial effect of povidone-iodine lasted for at least 24 hours after the completion of surgery.

Topics: Bacteria; Colony Count, Microbial; Conjunctiva; Drug Therapy, Combination; Endophthalmitis; Eye Diseases; Eye Infections, Bacterial; Gramicidin; Humans; Neomycin; Ophthalmic Solutions; Polymyxin B; Povidone-Iodine; Surgical Wound Infection

Between August 1982 and August 1984 3059 intraocular operations were performed with topical prophylactic antibiotics. Results of conjunctival cultures did not influence the surgical schedule. 8179 intraocular operations were performed between September 1984 and August 1988. An intraocular operation was postponed until conjunctival cultures were negative using topical antibiotics administered at hourly intervals. The rate of postoperative intraocular infections decreased significantly (p less than 0.0001) from 21 (0.69%) of 3059 during the first to 9 (0.11%) of 8179 intraocular operations during the second observation period. In the first period 11 vitrectomies and 2 enucleations due to bacterial endophthalmitis had to be performed. In the second period 2 vitrectomies and no enucleations were necessary (p less than 0.0001). Our results indicate, that decontamination of the conjunctiva may be an import factor for the prevention of postoperative endophthalmitis following elective intraocular surgery.

Topics: Adult; Aged; Bacterial Infections; Cataract Extraction; Colony Count, Microbial; Cross-Sectional Studies; Drug Therapy, Combination; Endophthalmitis; Eye Diseases; Germany; Gramicidin; Humans; Incidence; Keratoplasty, Penetrating; Lenses, Intraocular; Middle Aged; Neomycin; Ophthalmic Solutions; Polymyxin B; Premedication; Surgical Wound Infection; Trabeculectomy; Vitrectomy

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Dexamethasone; Eye Diseases; Framycetin; Gramicidin; Humans

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Dexamethasone; Eye Diseases; Framycetin; Gramicidin; Humans; Ophthalmology