Three-day application of topical ofloxacin reduces the contamination rate of microsurgical knives in cataract surgery: a prospective randomized study

Ophthalmology. 2004 Jul;111(7):1352-5. doi: 10.1016/j.ophtha.2003.10.032.


Purpose: To determine the rate of contamination of microsurgical knives during cataract surgery and the benefit of a 3-day versus a 1-hour preoperative application of topical ofloxacin in reducing the contamination rate.

Design: Prospective, randomized controlled trial.

Participants: Seventy-eight eyes of 75 patients were randomly assigned to control (39 eyes) or study groups (39 eyes).

Methods: All patients from both groups received 0.3% topical ofloxacin 1 hour before surgery, 5% povidone-iodine (PVI) scrub of the periorbital area, and 2 drops of PVI onto the ocular surface preoperatively. The patients in the study group also received ofloxacin 4 times a day for 3 days before surgery.

Main outcome measures: Microsurgical knives were placed in blood culture broth media immediately after the incision had been made. The number of positive cultures and types of bacteria isolated were determined.

Results: Ten of 39 knives (26%) in the control group were found to be positive for bacterial growth compared with only 2 of 39 (5%) in the study group (P = 0.028).

Conclusions: The initial paracentesis incision frequently results in contamination of the microsurgical knife and may serve as a mechanism for introducing bacteria from the ocular surface into the anterior chamber. The application of topical ofloxacin for 3 days before surgery significantly reduces the contamination rate of the microsurgical knives, compared with a preoperative application of ofloxacin given 1 hour before surgery.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Anti-Infective Agents / therapeutic use*
  • Antibiotic Prophylaxis*
  • Colony Count, Microbial
  • Conjunctiva / microbiology
  • Equipment Contamination / prevention & control*
  • Eye Infections, Bacterial / prevention & control*
  • Humans
  • Ofloxacin / therapeutic use*
  • Ophthalmic Solutions / therapeutic use
  • Phacoemulsification / instrumentation*
  • Prospective Studies
  • Time Factors


  • Anti-Infective Agents
  • Ophthalmic Solutions
  • Ofloxacin