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Polyhexamethylbiguanid as an Antiseptic Prophylaxis for Cataract-surgery
1Hansmann F., 2Ohgke H., 3Strobel H.-G., 4Kramer A., 1Geerling G.,
1Medizinische Universität zu Lübeck, Klinik für Augenheilkunde (Lübeck)
2Medizinische Universität zu Lübeck, Institut für Mikrobiologie und Hygiene (Lübeck)
3Medizinische Universität zu Lübeck, Apotheke des Universitätsklinikum (Lübeck)
4Ernst-Moritz-Arndt Universität Greifswald, Institut für Hygiene und Umweltmedizin (Greifswald)
Aim: Endophthalmitis is the most serious complication of intraocular procedures. 1.25% polyvinylpyrrolidon-(PVP)-Iodine is routinely used for intraoperative antiseptic prophylaxis. This can result in allergic reactions. A 0.04% solution of polyhexamethylbiguanid (PHMB) in combination with Polyethylenglycol may be an effective antiseptic alternative (Lavasept©, Fresenius-Kabi) that would avoid these iodine-associated side effects. In addition this substance is bound by mucous membranes in sufficient bactericidal concentrations for up to 3 days. The aim of this study is to examine the antiseptic potential and local tolerability of preoperative 0.04% PHMB for intraocular surgery.
Methods: In a randomised, controlled double blind study 0.04% PHMB, 1,25% PVP-Iodine or 0,9% saline-solution were applied in three groups of 10 patients three times preoperatively in addition to an intraoperative 1,25% PVP-iodine wash of the fornices. The degree of ocular surface symptoms, conjunctival hyperaemia and epitheliopathy as well as the bactericidal load of the conjunctiva were evaluated pre- and postoperatively.
Results: The additional preoperative use of 0.04% PHMB was well tolerated in all cases included so far. Further results of the ongoing double blind study will be presented once the randomisation code is revealed.
Conclusions: The application of Lavasept© as eye drops is well tolerated locally. It is hoped, that the additional use of 0.04% PHMB offers additional antiseptic protection.