Studying the effect of preoperative topical antibiotic drops on anterior chamber contamination after phacoemulsification

Objective Despite the application of aseptic protocols and the technical improvements of intraocular surgery, acute endophthalmitis is still noticed after cataract surgery. Presurgical prophylaxis was suggested to reduce the incidence of postcataract endophthalmitis. However, there is no clear protocol to follow. Aim The current study aimed to investigate the effect of preoperative topical antibiotics on anterior segment contamination in patients with cataract after phacoemulsification or phacotrabeculectomy. Patients, methods, and analysis The study enrolled 55 patients who underwent phacoemulsification or phacotrabeculectomy and intraocular lens implantation; 28 patients have used preoperative antibiotic drops (moxifloxacin 0.3%), and 27 patients did not use antibiotics. Anterior chamber (AC) aspirates were collected to determine the anterior segment microbial profile using microscopic examination and microbial cultures. Results All AC aspirates (100%) of the first group did not show any microbial growth on any culture media. However, bacterial growth was noted in three (11.1%) aspirates of the second group when cultured on blood, chocolate agar, and thioglycolate broth. Microscopic examination revealed Klebsiella pneumoniae, Escherichia coli, and Bacillus subtilis. All aspirates did not show any growth on Sabouraud dextrose agar. All patients were followed up after 1 day, 1 week, 1 month, and 3 months. Their ophthalmologic examinations were free of any abnormities. Conclusion Despite taking all the precautionary measures dictated by best practice guidelines for cataract surgery, there is minimal risk of AC bacterial contamination. Thus, the application of preoperative topical antibiotic drops is recommended for all cases.