Influence of special treatment of meibomian gland on the conjunctival sac's microorganisms before cataract surgery

Abstract

Objective To study the effect of the conjunctival sac's microbial condition after special treatment of meibomian gland including eye lid fomentation,massage and clean palpebral margin,to explore more and more safe preparation before ocular operation.Methods Eighty-seven cases of 90 eyes that needed the cataract surgery were divided into three groups randomly.A (blank group:without any treatments),B (control group:routine preparation preoperative including use of antibiotic eye drops + cut lashes + rinse tractus lacrimalis and conjunctival with isotonic Na chloride),C (treatment group:routine preparation preoperative + special treatment of meibomian gland).There were 25 cases of 26 eyes,29 cases of 29 eyes,33 cases of 35 eyes in each group respectively.Specimens of the conjunctival sac were collected at the admission (group A),at the start of the surgery and at the end of the surgery (group B and C),and sent to bacterial culture.Results Microbial culture positive rate of the conjunctival sac:in group A was 53.85％,at the start of the surgery and at the end of the surgery,the positive rates were 10.34％,27.59％ and 2.86％,5.71％ respectively in the group B and group C.Microbial culture positive rate of the conjunctival sac was decreased obviously in the group C (meibomian gland received the special treatment),there was statistical significance (P ＜0.05).There wasn't statistical significance between the microbial culture positive rate of the conjunctival sac and date of antibiotic eye drops used before surgery,time of the treatment of meibomian gland,duration of the surgery (P ＞0.05).The kinds of the microbial culture were 28 stocks and 5 genera totally,fungus was not detected.Conclusions There is a certain bacteria in the conjunctival sac of the normal population; routine preparation preoperative can reduce the microbial culture positive rate of the conjunctival sac,and reduce further after special treatment of the meibomian gland.On the condition of reduce the local use of antibiotic eye drops plus the special treatment of the meibomian gland before cataract surgery,also can gain the effect of clean operative field and reduce bacteria of conjunctival sac,thereby lower postoperative endophthalmitis rate. Key words: Cataract; Meibomian gland; Conjunctival sac; Microbial culture; Preoperative preparation