Perioperative liposomal ozonized oil can help reduce microbial flora in cataract surgery

This prospective, interventional, nonrandomized, paired-eye phase 4 clinical study conducted in Italy assessed the antimicrobial effectiveness of liposomal ozonized oil when administered prior to cataract surgery.

Study design

A total of 174 patients were given 1 of 2 treatments of liposomal ozonized oil in the 3 days before undergoing cataract surgery: either the study treatment consisting of 2 drops of an isotonic ophthalmic solution composed of liposomal ozonized 0.5% sunflower oil plus hypromellose 4 times daily or a control treatment (administered in contralateral eyes) of saline solution. All drops were applied at home. The main outcome was reduction in conjunctival microbial load. Adverse events and complications were also noted.

Outcomes

More than 90% of the samples taken from the eyes treated with liposomal ozonized oil presented a significant reduction (>90%) in microbial load. No changes in the microbial load were seen in the samples taken from the control eyes. The most prevalent bacteria seen were coagulase-negative staphylococci. The only adverse event reported was minimal conjunctival hyperemia, seen in 3 of the oil-treated eyes.

Limitations

Liposomal ozonized oil plus hypromellose is an unfamiliar compound for surgeons based in the United States.

Clinical significance

There is a need for a perioperative cataract surgery option beyond povidine iodine to reduce bacterial flora load and the potential risk for endophthalmitis. Liposomal ozonized oil plus hypromellose is a potential new option, and has low toxicity and allergenicity.