Abstract

P 225

Bacterial findings in lacrimal duct stenosis for an adequate postoperative antibiotic treatment

Verena Prokosch, Jan-Erik Prokosch, Julia Promesberger, Holger Bussse, Tobias Stupp
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Münster

Purpose
Lacrimal duct stenosis is a frequent, inconvenient and restricting medical condition affecting 5% of the population at every age. Despite effective surgical therapy restenosis occurs in 20% percent of the interventions and is due to microbiologic colonization (Walland et al., 1994).
Aims: To determine the current bacteriology of lacrimal duct obstruction and to adequate postoperative antimicrobial treatment to reduce restenosis after surgery caused by persistence of inflammation.
Methods
180 samples were obtained from the lacrimal duct of adult patients with lacrimal duct stenosis by irrigating the lacrimal drainage system with sterile saline and collecting the sample from the refluxing. The sample was cultivated for 4 days, bacterial isolates were analysed and susceptibility to antibiotics was tested.
Results
Cultures were positive from 60 % of the samples. Gram positive bacteria were isolated in 40% of the samples. The most frequently cultured bacterial species was Staphylococcus aureus representing 30% of the isolates. Gram negative bacteria were recovered from 20 % of the samples. 90% of the isolates were sensitive to gyrase inhibitors.
Conclusion
Lacrimal duct stenosis is attended by bacterial colonization, frequent by gram positive bacteria and staphyloccus aureus is a common agent.
The microbiological species and the sensitivity to antibiotics should be taken into account in pre- and postoperative treatment in order to reduce restenosis and chronic inflammation.
Studies looking at the rate of restensosis after adequate postoperative treatment are necessary.

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