RESUMEN
PURPOSE: To investigate ocular bacterial count before and after antisepsis with aqueous chlorhexidine (AC) or povidone-iodine (PI) and to assess discomfort with each agent. METHODS: Bacterial swabs were taken from participants' eyes before and after antisepsis. These underwent microscopy, culture, and sensitivity testing. Aqueous chlorhexidine drops were administered to left eyes and PI to right eyes. Participants rated their pain (scale 0-10) for each eye but were blinded to the type of drop. RESULTS: There were 20 participants (17 women, 3 men), and the mean age was 43 years. Pain scores were significantly higher in right (PI) than in left (AC) eyes (mean 7 vs. mean 2, P < 0.001). No abnormalities were detected on specimen microscopy and gram staining. Seven preantisepsis swabs (three left and four right) grew bacteria in culture. Two postantisepsis swabs grew bacteria in primary culture plate (1 after AC and 1 after PI). For an additional one post-PI swab, bacteria were detected in enrichment broth only. CONCLUSION: The efficacy of AC and PI are similar, and patient discomfort is lower with AC. Aqueous chlorhexidine is a good alternative to PI for antisepsis before intravitreal injection.
Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Antisepsia/métodos , Clorhexidina/administración & dosificación , Infecciones Bacterianas del Ojo/prevención & control , Dolor Ocular/inducido químicamente , Povidona Yodada/administración & dosificación , Administración Oftálmica , Adolescente , Adulto , Anciano , Antiinfecciosos Locales/efectos adversos , Bacterias/aislamiento & purificación , Clorhexidina/efectos adversos , Ojo/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Povidona Yodada/efectos adversos , Infección de la Herida Quirúrgica/prevención & control , Adulto JovenRESUMEN
A 70-year-old man had bilateral periorbital eyelid swelling. Eyelid biopsy confirmed amyloid infiltrate. Conjunctival involvement was not clinically apparent. The deposits were subsequently curetted with the use of a transcutaneous upper and lower eyelid blepharoplasty approach and found to be entirely pretarsal. No clinical recurrence of the ptosis was noted, but amyloid may have reaccumulated. We propose that in certain circumstances, debridement of localized amyloid should be considered and reaccumulation may not occur.
