Comparison of the Efficacy of Prophylactic Topical Antibiotics before Cataract Surgery

Winai Chaidaroon, M.D.
Pattamaporn Surawongsin, M.D.
Sumalee Pruksakorn, PhD.

ABSTRACT : Purpose : to compare the efficacy of 0.5% chloramphenical and 0.3% ciprofloxacin eyedrop combined with topical 5% povidone-iodine in the reduction of the normal bacterial ocular flora.
                    Methods : This is a prospective study. Ninety patients awaiting cataract surgery were randomly divided into three groups consisting of 30 patients each. The first group received 0.5% chloramphenical eyefrop, and the second 0.3% ciprofloxacin eyedrop to the eye at least 4 times preoperatively. The third group had no prophylactic antibiotic treatment. Cultures wrer obtained from both the lid margin and conjunctival fornix pre-and-post-antibiotic therapy. All groups were applied with 5% povidone-iodine before surgery. Microbiological identification, colony counts and antimicrobial sensitivity tests were performed.
                    Results : The mean age of the 90 patients was 67.6 years ? 11.4 (SD) (range 35 to 91 years). The mean bacterial colonies and species obtained from the eyelid and conjunctival fornix were not significantly different in 3 groups. A significantly lower number of mean colonies in both the eyelid (p = 0.028) and conjunctival fornix (p = 0.012) was observed in ciprofloxacintreated eyes compared with chloramphenicol-treated eyes. More than 90% reduction of mean colonies on the conjunctival fornix was found in 0.3% ciprofloxacin combined with 5% of the povidone-iodine group.
                    Conclusion : This study attempts to compare the efficacy of 0.5% chloramphenical and 0.3% ciprofloxacin eyedrops that are commonly used before cataract extraction by physicians who assume prophylaxis as a practical value. The data showed that 0.3% ciprofloxacin eyedrop can minimize the mean number of colonies on the eyelid and conjunctival fornix. Species on the conjunctival fornix differed significantly when compared with 0.5% chloramphentcal eyedrop. Larger sample sizes should be considered in further studies.

Thai J Ophthalmol 2001 ; January-June 15(1) : 17-26.

Key word : normal ocular bacterial flora, cataract extraction, chloramphenical,ciprofloxacin, Staphylococcus haemolyticus, Staphylococcus epidermidis, Staphylococcus aureus, Propionibacterium, acnes.