DOES CONJUNCTIVAL CULTURE BEFORE ROUTINE CATARACT SURGERY PREVENT ENDOPHTHALMITIS IN PREDISPOSED HIGH RISK PATIENTS?

To report the importance of preoperative bacterial culture from the conjuctival culde sac in contralateral eye of pateient with endophthalmitis

tertiary care hospital, western India

A 53 years gentleman with previous history of post cataract endophthalmitis posted for other eye cataract surgery.h/o of post cataract endophthalmitis in the other eye that required core vitrectomy

In view of endophthalmitis in the other eye, conjunctival swab for bacterial culture and sensitivity was taken and based on the report   

appropriate topical and systemic antibiotics were started prior to the elective cataract surgery

Results of Conjunctival culture was positive for gram +ve cocci, sensitive to moxifloxacin and resistant to vancomycin.The same organism with identical antibacterial sensitivity pattern was isolated from the vitreous sample of the previously affected eye with endophthalmitis.

Patient was started on topical 0.5 % moxifloxacin and systemic moxifloxacin 3 days prior to cataract surgery.A repeat conjunctival swab showed no growth of organisms following which he underwent uneventful phacoemulsification with excellent outcome without any signs of endophthalmitis

In predisposed patients viz. those with endophthalmitis or systemic infections, conjunctival swab with bacterial culture may be an important step in preventing endophthalmitis in subsequent Surgical procedures in the same or fellow eye. Conjunctival swab may be considered as part of the routine preoperative work up in such individuals at risk