Clear corneal wound infection can occur after phacoemulsification

WESTPORT, CT (Reuters Health) – The results of a recent study suggest that although rare, clear corneal wound infection after phacoemulsification is a serious complication of cataract surgery.

Dr. Elisabeth J. Cohen, of the Wills Eye Hospital, Philadelphia, and colleagues retrospectively reviewed the medical records of seven patients who developed this complication following phacoemulsification.

The investigators reviewed patient age, sex, symptom onset after surgery, possible risk factors for infection, concomitant ocular disease, and perioperative prophylactic antibiotic and steroid use. They also examined culture and antibiotic sensitivity results, treatment regimen and outcome.

The median onset of signs and symptoms after surgery was 10 days, and ranged from 4 days to 60 days, according to the report in the December issue of the Archives of Ophthalmology. "Corneal cultures yielded methicillin-resistant Staphylococcus aureus in two cases, Streptococcus pneumonia in one case, and Staphylococcus epidermidis in one case," the team notes.

No microorganisms were found in cultures from one patient, and cultures were not obtained for two patients.

The isolated microorganisms were resistant to the perioperative prophylactic antibiotics, including fluoroquinolones and tobramycin, in three of the four patients with positive cultures. Other than the use of steroids four times a day by one patient, the team observed no possible risk factors for infection.

"Six of these seven wound infections healed with topical antibiotic therapy," the authors explain. "One of the patients required lamellar keratectomy and conjunctival flap for complete healing." Best-corrected visual acuity at last follow-up was better than 20/40 in four patients.

Arch Ophthalmol 2001;119:1755-1759.

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