The eye wipes with polyhexanide (HexaClean) in preoperative prophylaxis of cataract surgery

Abstract

Background: Progressively increasing number of eye surgeries forces the development of simple-to-use, effective methods to reduce the risk of postoperative endophthalmitis. We wondered whether the eyelid margin wipes containing 0.1% polyhexamethylene biguanide (PHMB) (HexaClean, VERCO, Poland) influence the reduction of bacterial flora localized in the conjunctival sac and whether it can be used for prophylaxis before the cataract surgery. Material and methods: 95 patients before the cataract surgery were included in the study. The conjunctival swab was collected from patients twice — before using eye wipes and after 5 days of eye wipes usage. The swabs were plated on microbiological enriched media and incubated under aerobic and microaerophilic conditions for 24–48 hours at 35°C ± 2°C. Then the identification of microorganisms was carried out using classic microbiological methods and tests. Results: Bacterial strains were isolated from the conjunctival sac in 84% of patients before using the eye wipes. The largest group of isolated pathogens was Gram-positive cocci, and these were mainly methicillin-sensitive and methicillin-resistant coagulase-negative staphylococci, which accounted for 72% of isolated strains. When the eye wipes were used, the bacterial flora was eliminated from the conjunctival sac in 54% of patients. A reduction in isolated strains and decreased variety of bacteria was observed in another 22% of patients. Conclusion: These results indicate that the application of eyelid wipes with polyhexanide reduces a significant amount of the conjunctival sac microbiota, which may prevent inflammation after cataract surgery.