Abstract
The aim of this study was to investigate the effect of topically applied ocular anesthetic proparacaine on conjunctival and nasal bacterial mucosal flora in patients with dry eye disease. A Schirmer test was done with (group 1) and without (group 2) topical anesthetic proparacaine to 40 patients in each group. Conjunctival and nasal cultures were obtained before and 10 min after performing the Schirmer test. The bacterial culture results and the isolated bacteria were recorded in two groups. Patients’ mean age was 62 years (70 female, 10 male). Before the application of topical anesthetic, 50 (62.5%) and 62 (77.5%) had positive conjunctival and nasal culture, respectively, with the most commonly isolated organism being coagulase-negative Staphylococcus in each group. In group 1 the conjunctival bacterial culture positivity rate decreased from 26 (65%) to six (15%) eyes (p < 0.001); however, this rate decreased slightly from 24 (60%) to 20 (50%) eyes in group 2 (p > 0.05). For the nasal cultures, the bacterial culture positivity rate decreased from 80% to 20% and from 75% to 65% in groups 1 (p < 0.001) and 2 (p > 0.05), respectively. Topical ocular anesthetic proparacaine has antibacterial activity in both conjunctival and nasal flora in patients with dry eye disease.
Highlights
In vivo non-ophthalmological trials and more recently in vitro and in vivo ophthalmological studies have provided consistent evidence demonstrating the antibacterial activity of topical anesthetics [1,2,3]
The bacterial culture positivity rates were higher in nasal cultures, which were 80% (32/40) and 75% (30/40) in groups 1 and 2, respectively
We examined the effects of the topically applied ocular anesthetic proparacaine on the nasal cavity flora and found that the nasal cavity flora was affected by proparacaine in patients diagnosed with dry eye syndrome
Summary
In vivo non-ophthalmological trials and more recently in vitro and in vivo ophthalmological studies have provided consistent evidence demonstrating the antibacterial activity of topical anesthetics [1,2,3]. The antibacterial activity of proparacaine, a common topical anesthetic agent, has previously been demonstrated against ocular bacterial flora [6,7]. The ocular surface of healthy individuals inherently supports a small population of bacteria, typically coagulase-negative staphylococci (CNS), which are believed to exist as commensals on the mucosa [8]. Similar symptoms commonly occur in dry eye, without evidence of purulent exudative infection. Schirmer test is commonly used to evaluate and confirm dry eye disease. Schirmer test can be performed with or without topical anesthesia [10]
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