Antibiotics in irrigation solution for cataract surgery. A laboratory investigation of the pharmacological stability and bacteriological susceptibility

Abstract

Purpose: To evaluate the appropriateness of a prophylactic use of Gentamicin and Vancomycin in the irrigation solution for cataract surgery. Methods: A laboratory study of the pharmacological stability and the bacteriological susceptibility of the two antibiotics and epinephrine in the irrigation solution. Results: Gentamicin and Vancomycin are pharmacologically stable in concentrations above the MIC-values of most Gram positive and Gram negative bacteria without reaching toxic levels. Conclusion: Although it seems tempting to add Gentamicin and Vancomycin in irrigation solutions for cataract surgery, major objections to such a prophylactic use of antibiotics have been stated, specially focusing on the risk of emerging resistance to the antibiotics, and the financial implications.