The Importance of Eyelid Margin Hygiene in Cataract Surgery Preparation
str. 54 – 58
Autorzy: Aleksandra Opala 1 , Łukasz Kołodziejski 1 , Ewa Swoboda-Kopeć 2 , Magdalena Sikora 2 , Katarzyna Piskorska-Małolepsza 2 , Maciej Osęka 3 , Iwona Grabska-Liberek 1
1 Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Samodzielny Publiczny Szpital Kliniczny im. prof. W. Orłowskiego w Warszawie
Kierownik: prof. dr hab. n. med. Iwona Grabska-Liberek
2 Katedra i Zakład Mikrobiologii Lekarskiej Warszawskiego Uniwersytetu Medycznego
Kierownik: prof. dr hab. n. med. Grażyna Młynarczyk
3 Ofta Sp. z o.o.
Objective: To assess the effectiveness of hygiene routines using wet tissues with polyhexamethylene biguanide (PHMB; HexaClean, Ofta) to wipe eyelid-margins in order to reduce the bacterial flora of the conjunctival sac in cataract patients preparing for a phacoemulsification with intraocular lens implantation.
Methods: The study included 41 patients (16 men and 25 women) aged between 60 to 89 years (mean age 72.7 years) preparing for cataract surgery. Patients, meeting the inclusion criteria and having given their written consent, were qualified for the study. Wet tissues with polyhexamethylene biguanide were used before the surgery. Patients underwent two examinations prior surgery, the first one before the implementation of the eyelid-margin hygiene routine and the second one five to seven days after starting the wet tissue routine. At every examination they filled in questionnaires about their subjective symptoms when using the tissues, the anterior segment of the eye was examined using a slit lamp and a conjunctival swab was taken and cultured. Clean cultures were identified using mass spectrometry. The conjunctival bacterial flora and the subjective and objective symptoms in the anterior segment of the eye before and after tissue routine implementation were assessed.
Results: The swab taken before the tissue routine implementation was positive in 55.3% (n = 21) of the patients. Staphylococcus epidermidis was the most commonly isolated microorganism (66.7%, n = 16) in the conjunctival sac. After tissue routine implementation, the conjunctival swab was positive in 39.5% (n = 15) of patients. S. epidermidis represented 75% of the conjunctival bacterial flora. The percentage of patients with a positive swab and objective symptoms in the anterior segment of the eye decreased from 55.3% (n = 21) to 39.5% (n = 15) after implementation of the hygiene routine.
Conclusions: Eyelid-margin hygiene routines using wet tissues with polyhexamethylene biguanide effectively reduce the bacterial flora in the conjunctival sac of patients preparing for cataract surgery.