Purpose To investigate the potential risk of residual lens cortex following phacoemulsification cataract surgery in the development of endophthalmitis.
Method The aqueous humor and lens cortex material were harvested from senile cataract patients during surgery.Staphylococcus aureusandStaphylococcus epidermidiswere dispensed into the aqueous humor and serial dilutions (1:1 to 1:16) of the lens cortex material, respectively. After incubation for 48 h, the colony-forming unit (CFU) count of each organism was examined. Eighty rabbits underwent phacoemulsification lens extraction surgery. Complete lens cortex removal was performed on 40 rabbits. In another 40 rabbits, approximately a quarter of lens cortex was retained.S. aureus, with an inoculom size of 32 CFU, 56.3 CFU, and 108.6 CFU, was injected into the anterior chamber at the conclusion of the surgery. After observation for 72 h, the production of endophthalmitis was measured. The aqueous and vitreous humor samples were collected for further microbiological diagnosis.
Results A statistically significant increase in bacterial growth of bothS. aureusandS. epidermidiswas observed in each dilution of lens cortex material when compared with that in aqueous humor. With inoculum of 32 CFU or 56.3 CFU, there is statistically more production of endophthalmitis in the residual lens cortex eye group than in the normal aphakic eye group after microbiological diagnosis.
Conculsion Lens cortex material is more appropriate as a bacterial culture medium than aqueous humor. The eye with residual lens cortex is more prone to suffer endophthalmitis if anterior chamber bacterial contamination occurs during phacoemulsification surgery. |
