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Klin Monbl Augenheilkd 2006; 223(5): 357-360
DOI: 10.1055/s-2006-926558
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Bakterielles Kontaminationsrisiko nach Povidon-Iod-Desinfektion in der Kataraktchirurgie

Risk of Bacterial Contamination after Povidone-Iodine Disinfection for Cataract SurgeryA. Yanar1 , R. Zbinden2 , M. de Melo2 , A. J. Trick1 , R. Kovacs1 , M. A. Thiel1
  • 1Universitäts-Augenklinik Zürich, Zürich, Direktion: Prof. Dr. Klara Landau
  • 2Institut für Mikrobiologie, Zürich, Direktion: Prof. Dr. Erik Christian Böttger
Further Information

Publication History

Eingegangen: 5.10.2005

Angenommen: 30.11.2005

Publication Date:
16 May 2006 (online)

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Zusammenfassung

Hintergrund: Die präoperative Desinfektion mit Povidon-Iod-Augentropfen mit oder ohne Antibiotika wird in der Kataraktchirurgie oft verwendet. Bei kombinierter Verwendung von 5 % Povidon-Iod und Ofloxacin liegt die Kontaminationsrate der verwendeten Parazentheselanzen und Tunnelmesser bei 26 %. Ziel der Studie war die Untersuchung der Kontaminationsrate bei alleiniger Prophylaxe mit 0,8 % Povidon-Iod. Patienten und Methoden: Bei 126 konsekutiven Patienten mit elektiver Kataraktoperation mit Bindehauteröffnung und sklerokornealem Tunnel wurde eine präoperative Desinfektion der Binde- und Hornhaut mit Povidon-Iod-Augentropfen durchgeführt (Braunol® 1:10 verdünnt = 0,8 % Povidon-Iod, 3-mal im Abstand von je 5 min). Zur Beurteilung der im Anschluss an die Desinfektion persistierenden, oberflächlichen Keime wurden die intraoperativ verwendeten Parazentheselanzen und die Tunnelmesser nach der Schnittführung für die mikrobielle Kultur in Thioglykolat asserviert. Ausgepackte, aber nicht verwendete Messer dienten als Kontrollen. Ergebnisse: Bei nur 8 von 126 Patienten (6 %) fand sich eine positive Kultur (89 % Koagulase negative Staphylokokken). Vier der acht Kontaminationen der Messer ereigneten sich an einem Halbtag. Keines der 36 Kontrollmesser war kontaminiert. Schlussfolgerungen: Die alleinige Desinfektion mit verdünntem Povidon-Iod ist sehr effektiv, wenn sie zuverlässig durchgeführt wird. Die Kontaminationsrate liegt bei der Verwendung von 0,8 % Povidon-Iod deutlich tiefer als früher publizierte Vergleichsdaten mit 5 % Povidon-Iod in Kombination mit Ofloxacin.

Abstract

Background: Povidone-iodine alone or in combination with antibiotics is commonly used for presurgical disinfection in cataract surgery. In spite of the use of the combination Povidone-iodine and ofloxacin, the rate of ocular contamination as assessed from surgical knives was reported to be as high as 26 %. The aim of this study was to investigate the efficacy of diluted Povidone-iodine alone for surgical disinfection. Patients and Methods: 126 consecutive patients undergoing elective cataract surgery with a conjunctival wound and a scleral tunnel received prior to surgery a disinfection with diluted Povidone-iodine eye drops (Braunol® 1:10 diluted = 0.8 % Povidone-iodine, 3 times every 5 min). To assess residual bacteria on the ocular surface after disinfection, the surgical knives for the side ports and the scleral tunnel were cultured in thioglycolate broth. Results: In 8 out of 126 (6 %) patients the culture from the surgical knives revealed a positive result (89 % coagulase negative Staphylococci). Four of these 8 cases occurred during a single list. All control cultures remained negative. Conclusion: Diluted Povidone-iodine eye drops alone are highly effective for bacterial disinfection when applied properly. The rate of contamination using 0.8 % Povidone-iodine in our series was considerably lower as compared to that of other studies.

Schlüsselwörter

Povidon-Iod - Desinfektion - Antibiotika - Kataraktchirurgie

Key words

Povidone-iodine - disinfection - antibiotics - cataract surgery

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Dr. med. A. Yanar

Augenklinik Universitätsspital Zürich

Frauenklinikstrasse 24

8091 Zürich

Schweiz

Phone: ++ 41/44/2 55 49 13

Fax: ++ 41/44/2 55 44 72

Email: Ahmet.Yanar@usz.ch