Changes in the Conjunctival Flora after Conjunctivodacryocystorhinostomy (CDCR): A Preliminary Report

Abstract

PURPOSE: To describe changes in the conjunctival flora due to retrograde flow after conjunctivodacryocystorhinostomy (CDCR) with Jones' tube implantation. METHODS: In 20 patients, one year after unilateral CDCR with Jones' tube implantation and a functionally successful outcome, conjunctival and nasal mucosal specimens were taken from the operated side for bacteriological analyses and non-operated eye conjunctival specimens were simultaneously taken as the control group. The samples were cultivated in conventional media and also in hypertonic media in order to isolate L-forms of bacteria and to increase the isolation rate and sensitivity. RESULTS: Bacterial growth was detected in 16 operated (80%) and 11 non-operated eyes (55%) and 26 bacteria were isolated from nasal mucosa in 20 cases (isolation rate 100%). Bacteria isolated from the non-operated specimens were S. epidermidis (63.6%, seven cases), S. aureus (27.2%, three cases) and Corynebacterium sp. (9.0%, one case). Conjunctival cultures of the operated eyes yielded S. epidermidis in three (18.7%), S. aureus in six (37.5%), Corynebacterium sp. in two (12.5%) and other bacteria in five (31.3%). Nasal mucosal cultures contained S. epidermidis in nine cases (45%), S. aureus in eight (40%), Corynebacterium sp. in two (10%) and miscellaneous bacteria in seven cases (35%). CONCLUSIONS: After CDCR the conjunctival flora of the eye undergoes differentiation and becomes similar to the nasal flora.