Quantification of incidental needle and suture contamination during strabismus surgery

Binocul Vis Strabismus Q. 2003;18(2):75-9.


Purpose: To quantify the level of bacterial contamination of needles and sutures immediately after use in strabismus surgery.

Methods: Strabismus surgery was performed on 56 eyes from 31 pediatric strabismus surgical cases. Preoperative site preparation included instillation of 5% povidone-iodine in the conjunctival fornices in all cases. A total of 124 needles and 127 sutures were cultured immediately after final scleral passage.

Results: Seventeen of the 31 cases (54.8%) produced at least one positive specimen. Nineteen per cent of the needles and 25.2% of the sutures were culture positive. The bulk of positive specimens (96.7% of needles, 91.3% of sutures) produced 3 or less colony forming units, corresponding to 7 or less total viable organisms per needle or sutures in accordance with the dilution scheme. Coagulase-negative staphylococci overwhelmingly predominated.

Conclusions: Needles and sutures used in strabismus surgery can become contaminated during surgery despite preoperative povidone-iodine preparation. The number of viable bacterial contaminants is usually below the level known to consistently produce experimental endophthalmitis. However, a few needles and sutures carried a high contaminant load, suggesting the possibility that contaminated needles and sutures could potentially cause postoperative intraocular infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bacteria / isolation & purification*
  • Bacteriological Techniques
  • Child
  • Child, Preschool
  • Colony Count, Microbial
  • Endophthalmitis / microbiology
  • Endophthalmitis / prevention & control
  • Equipment Contamination*
  • Eye Infections, Bacterial / microbiology
  • Eye Infections, Bacterial / prevention & control
  • Female
  • Humans
  • Infant
  • Male
  • Needles / microbiology*
  • Strabismus / surgery*
  • Sutures / microbiology*