Antibiotics in the irrigating solutions reduce Staphylococcus epidermidis adherence to intraocular lenses

Purpose To investigate the effect of antibiotics in the irrigating solutions on hydrophobicity, slime production and the adherence of Staphylococcus epidermidis to intraocular lenses (IOLs). Methods A standard culture of S. epidermidis was incubated with a control phosphate-buffered saline (PBS) or PBS containing vancomycin (20 mu g/ml) or gentamicin (8 mu g/ml) or a combination of gentamicin and vancomycin (8 and 20 mu g/ml, respectively) for 30, 60 and 120 min at 35 degrees C. The bacteria were harvested by centrifugation, and washed with PBS before incubation with IOLs for 1 h. Adhesion of bacterial cells to IOLs was determined by counting the viable cells attached to the lenses. Slime production on IOLs was measured using safranin staining. Hydrophobicity of the control cultures and cultures treated with antibiotics was assayed on the basis of the hexadecane droplet method. Results Bacterial exposure to antibiotics produced a time-dependent significant decrease in bacterial hydrophobicity and adherence to IOLs compared with the untreated control cells (p < 0.001). Hydrophobicity showed a significant correlation with adherence (r = 0.89, p < 0.001). Gentamicin was significantly more effective than vancomycin, and the synergistic combination of gentamicin and vancomycin was the most effective in reducing bacterial adherence to IOLs, hydrophobicity and slime production. Conclusions The use of antibiotics in the irrigating solutions during cataract surgery may be useful in reducing bacterial adherence to IOLs. Further studies are needed to determine the clinical implications of these findings in reducing the incidence of postoperative endophthalmitis associated with IOL implantation.