Anterior chamber concentrations of vancomycin in the irrigating solution at the end of cataract surgery

Purpose: To verify that therapeutic levels of vancomycin were present in the irrigating solution at the end of cataract surgery. Setting: Service d'ophtalmologie, Universite de Limoges, France. Methods: An irrigating solution that contained 20 mg/L of vancomycin was used in 15 patients having phacoemulsification. Antibiotic concentrations in the phacoemulsification handpiece and in the aqueous humor were measured at the end of surgery. Results: Passage through the phacoemulsifier did not affect antibiotic concentration. In the aqueous humor, after wound closure, the concentration constantly exceeded the minimal inhibitory concentration of the principal gram-positive bacteria responsible for human endophthalmitis. Conclusion: Vancomycin added to the irrigating solution used during cataract surgery was found in effective concentrations in the anterior chamber at the end of surgery.