Cataract Surgery Clinical Trial
Official title:
Assessment of Conjunctival Flora and Optimal Ocular Sterilization Technique Prior to Cataract Surgery Using Intranasal Mupirocin Ointment
The purpose of this study is to evaluate the conjunctival flora prior to cataract or vitrectomy surgery comparing mupirocin ointment applied to the conjunctiva along with standard ocular sterilization vs. standard ocular sterilization alone.
Bacterial endophthalmitis is a rare but devastating complication of intraocular surgery.
Given the devastating ocular sequelae of endophthalmitis, one cannot underestimate the need
to develop a sterilization strategy which most effectively prevents intraocular infection.
The most common organisms causing bacterial postoperative endophthalmitis are gram-positive
cocci, particularly coagulase-negative staphylococci and Staphylococcus Aureus. It is
thought that the most common sources of bacterial contamination predisposing to
endophthalmitis are the eyelids and conjunctiva (Ariyasu).
The two main techniques used to reduce the bacterial flora on the ocular surface include
treatment of the ocular surface with topical antibiotics prior to surgery and the
instillation of 5% povidone-iodine during the prep immediately prior to beginning the
surgical procedure (Speaker). Mupirocin ointment is a logical choice for surgical
prophylaxis as it has been reported that mupirocin treatment applied to the nose resulted in
elimination rates (of S. Aureus from the nares) of 91% directly after therapy (Doebbeling).
Use of mupirocin ointment applied to the nares prior to eye surgery resulted in a
significant decrease in the bacterial load on the conjunctiva at the time of surgery
(Alexandrou, in press). Using mupirocin ointment directly to the conjunctiva, in addition to
standard ocular sterilization techniques, may result in an even greater decrease in
conjunctival flora prior to eye surgery.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Prevention
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