Impact of eyelid hygiene on conjunctival microbial species and ocular discharge in patients with ocular prostheses

Purpose To evaluate the impact of eyelid hygiene on conjunctival microbial species and ocular discharge in patients with ocular prostheses(OP). Methods A prospective study included patients with unilateral anophthalmic sockets or phthisis bulbi using OP. Two visits were scheduled: baseline and 7 days later. At each visit, three samples were collected: lower tarsal conjunctiva of the affected eye, bulbar conjunctiva of the affected eye, and lower tarsal conjunctiva of the healthy eye. Patients followed one of two hygiene regimens: Ozonest ® group (wipes and liposomal-ozonated-oil drops) or Lephanet ® group (wipes and saline solution). Demographic data, clinically significant discharge(CSD), and eyelid cleaning habits were recorded. Statistical significance was set at P < 0.05. Results Sixty-one patients (mean age 63.7 ± 15.5 years, 54.1% male) contributed 366 samples. 31 (50.8%) were in Ozonest and 30(49.2%) in Lephanet. Staphylococcus epidermidis (39%) and Corynebacterium macginleyi (24.6%) were most common. Positive cultures were higher in affected eyes (78.7%) than in healthy eyes (32.8%, P < 0.05). Tarsal conjunctiva cultures decreased with both Ozonest(64.5% to 51.6%) and Lephanet (56.7% to 46.7%). Overall CSD decreased from 47.5% to 16.4%, particularly in Lephanet (60% to 10%, P < 0.05). Conclusions Positive cultures were more frequent in prosthetic eyes than in healthy eyes being with S. epidermidis and C. macginleyi being the most frequent microorganisms. Both hygiene regimens reduced positive tarsal conjunctival cultures and improved CSD.