Author(s): Courtright P, Lewallen S, Holland SP, Wendt TM
Abstract Share this page
Abstract PURPOSE: During 5 days in January 1994, two visiting expatriate ophthalmologists performed extracapsular cataract surgery on 111 patients at a nonprofit hospital in Asia. The authors investigated the development of postoperative corneal edema. METHODS: An epidemiologic and clinical investigation was undertaken by a review of clinical charts, interview of personnel involved, an examination and interview of patients who underwent surgery, and a laboratory simulation of the disinfection procedure used. RESULTS: Follow-up was available on 58\% of the patients. The attack rate was at least 37\% and likely to be approximately 64\%. The attack rate was highest the first 2 days of surgery. Multivariate analysis showed that the day of surgery was the only characteristic significantly associated with the presence of corneal edema. A simulation of the disinfection technique used (soaked in 2\% glutaraldehyde and rinsing) showed that significant levels of glutaraldehyde remain in instruments with small lumens after the rinse. CONCLUSION: The epidemiologic data and simulation information are compatible; the lack of adequate rinsing of small lumen instruments soaked in glutaraldehyde is the most probable cause of this incident. Recommendations for surgeons on surgical expeditions are proposed.
This article was published in Ophthalmology
and referenced in Journal of Stem Cell Research & Therapy