Daneshmand E. The efficacy of prophylactic methods of surgical area treatment for prevention of postoperation infection complication in ophthalmology.

The thesis is dedicated to investigation of the efficacy of different methods of preoperative antimicrobial prophylaxis of surgical area in ophthalmic surgery. We found that using topical preoperative antibiotic prophylaxis or single surface treatments with antiseptic at the beginning of the operation does not allow providing sterility of conjunctival sac, eyelid edge and anterior chamber fluid during ophthalmic surgery. After flushing with the sterile isotonic solution of sodium chloride no difference was found between bacterial contamination of conjunctival sac or eyelid edge. After preoperative antimicrobial prophylaxis incidence of anterior chamber bacterial contamination is similar among eyes undergoing cataract extraction and cataract extraction with implantation intraocular lens. During ophthalmic surgery flora of the conjunctival sac is transient but flora of the eyelid edge is resident. Covering and isolating of superior and inferior eyelid skin, eyelash, lid margin, palpebral conjunctiva and fornix with sterile tissue napkins rinsed in 0.02% aqueous solution of chlorhexidine in combination with preoperative topical lipophilic antibiotic prophylaxis allows providing sterility of anterior chamber fluid during phacoemulsification. In vitro investigation showed that antimicrobial effect of sterile tissue napkins rinsed in 0.02% aqueous solution of chlorhexidine preserves to the end of phacoemulsification. The preoperative conjunctival culture may not be useful in predicting the bacterial contamination of conjunctival sac during ophthalmic surgery.