PREOPERATIVE EYE DISINFECTION IN VITRECTOMY SURGERY USING ANTIBIOTIC OR ANTISEPTIC EYEDROPS VANINBROUKX I., 1 VAN CALSTER J., 1 VAN CALSTER B., 2 SPILEERS W., 1 VERHAEGEN J., 3 STALMANS P., 1 ABSTRACT Purpose: To determine the efficacy of preoperative eye disinfection by comparing antibiotic and anti- septic eye drops. Design: Prospective, randomized double-masked com- parative study with three study arms: untreated, an- tibiotic treated and antiseptic treated. Methods: Patients that were scheduled for vitrecto- my were asked to use an antibiotic or antiseptic eye drop 4 times a day, 5 days before the surgery. Con- junctival smear was cultured at the onset of the sur- gery. Culture results for each study arm were com- pared . Results: Comparable results were found in the pa- tients treated with an antibiotic or antiseptic eye drop. Conclusions: Since an antiseptic eye drop will cause less bacterial resistance than an antibiotic eye drop, and both treatments have a similar antibacterial ef- fect, this study indicates that prophylactic antisep- tic eye drops may be preferred over antibiotic treat- ment, when prophylaxis is needed. KEY WORDS Endophthalmitis, hexamedine di-isetionate, preoperative disinfection, vitrectomy INTRODUCTION The incidence of postoperative infection after vitrectomy surgery varies between 0,03% and 0,07% (1,2,3). Endophthalmitis is a rare but devastating complication. It is mostly caused by commensal bacterial flora of the conjunc- tiva, the eyelids, the nose and the periocular skin (4,5). The most common responsible or- ganisms are Staphylococcus epidermidis and other coagulase negative Staphylococ- ci (5,6,7). These organisms are able to adhere to foreign bodies, probably by formation of gly- cohelix bonds (8). Other pathogenous bacteria include Coryne- bacterium species, Streptococcus viridans, Sta- phylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumoniae. Preoperative application of antibiotic drops may induce bacterial resistance. Recently, an anti- septic solution of hexamedine di-isetionate 1 mg/ml (Desomedinet, Chauvin, Montpellier, France) became available for preoperative eye disinfection. Using an antiseptic rather than an antibiotic drop may reduce the risk of endoph- thalmitis without inducing bacterial resistance to antibiotics. The aim of this study was to evalu- ate the sterilizing effect of hexamedine di-ise- tionate on the conjunctiva and comparing its effect to a popular antibiotic drug: ofloxacine (Trafloxalt, Tramedico, Weesp, The Nether- lands). zzzzzz 1 Department of Ophthalmology University Hospitals Leuven 2 Catholic University Leuven Department of Electrical Engineering (ESAT_SCD) 3 Department of Laboratory Medecine, University Hospitals Leuven Submitted: 02-04-10 Accepted: 20-06-10 9 Bull. Soc. belge Ophtalmol., 315, 9-12, 2010.