Objective: To investigate the effect of three preoperative anti-infective regimens on the sterility of anterior-chamber aspirates (ACA) in eyes undergoing extracapsular cataract extraction (ECCE). Methods: Ninety eyes scheduled to undergo ECCE were randomly assigned to receive one of the following preoperative anti-infective regimens: Group 1 (Control) - no additional preoperative preparation; Group 2 (Eye drop) - neomycin/ polymixin B/gramicidin eye drops applied 3 times daily for 3 days prior to surgery; and Group 3 (Lid scrub) - neomycin/polymixin B/ bacitracin ointment lid scrub applied 3 times prior to surgery. ACAs were obtained from all eyes at the conclusion of surgery and cultured. The patients were followed up for 3 months after the surgery. Results: Positive cultures developed from ACAs in 5 (16.6 percent) of 30 eyes from Group 1, in 0 of 30 from Group 2, and in 3 (10 percent) of 30 from Group 3. No eye developed endophthalmitis. Compared with the control group, preoperative neomycin/polymixin B/gramicidin eye drops significantly reduced the ACA contamination rate (p= 0.03). Conclusion: Preoperative neomycin/polymixin B/bacitracin eyedrops can improve the sterility of the anterior chamber during ECCE.
Human ; CATARACT ; ANTI-INFECTIVE AGENTS ; ENDOPHTHALMITIS ; NEOMYCIN ; GRAMICIDIN ; BACITRACIN ; CATARACT EXTRACTION ; EYE DISEASES ;

Objective: To determine the in-vitro activity of voriconazole and compare it with amphotericin B, fluconazole, itraconazole, ketoconazole, and caspofungin against local yeast and mold clinical isolates Candida albicans, Candida sp., Aspergillus terreus, Aspergillus niger, and Fusarium cylindrocarpone. Methods: Review of the Institute of Ophthalmology microbiology records were done and was the basis for the local isolates included in the study. Mean inhibitory concentration (MIC) was determined using YeastOne Sensititre Microtitre Colorimery method (TREK Diagnostic Systems, England). Two-way ANOVA, Duncan, and Pearson chi-squared tests were used to analyze the data. Results: All isolates tested were sensitive to voriconazole. Eighty percent (80%) of the isolates were sensitive to amphotericin B and 25% showed resistance to itraconazole. Yeast pathogens were all sensitive to amphotericin B and voriconazole. More than 50% of the yeast pathogens were resistant to ketoconazole. Molds or filamentous fungi showed higher susceptibility to voriconazole than amphotericin B and the other antifungals. Conclusion Voriconazole exhibited good in-vitro activity against the isolates tested. It has the same efficacy on yeast pathogens (Candida albicans and Candida sp.) when compared with amphotericin B. It has superior efficacy on filamentous fungi (Aspergillus and Fusarium). There is a role for voriconazole in the treatment of ocular infections, especially in the setting of poor antifungal drug availability.
Voriconazole ; Amphotericin B ; Candida ; Fusarium ; Aspergillus