方法：选取2015-01/11在我院拟行白内障超声乳化手术的年龄相关性白内障患者216例216眼随机分成A(72眼)、B(72眼)、C(72眼)三组，术前分别采用3g/L妥布霉素滴眼液、5g/L左氧氟沙星滴眼液及上述两种滴眼液点眼； 再随机分为莫西沙星组(110眼)和聚维酮碘组(106眼)，分别于术野常规消毒后手术正式开始前使用1.6g/L莫西沙星和5g/L聚维酮碘冲洗结膜囊。分别于入院未用药前、手术未消毒前及结膜囊冲洗后采集术眼睑缘和结膜囊标本，术毕采集结膜囊标本并抽取前房水进行常规细菌培养及药敏试验。

结果：白内障患者术前睑缘、结膜囊细菌培养阳性率分别为86.6%、25.0%。A、B、C组患者应用不同抗生素滴眼液点眼前后睑缘细菌培养阳性率分别为86.1%和36.1%、84.7%和31.9%、88.9%和30.6%； 结膜囊细菌培养阳性率分别为25.0%和11.1%、26.4%和11.1%、23.6%和8.3%。采用莫西沙星和聚维酮碘组进行结膜囊冲洗前后睑缘细菌培养的阳性率分别为33.6%和10.9%、32.1%和10.4%； 结膜囊细菌培养的阳性率分别为10.0%和0、10.4%和0。

结论：白内障术前联合使用3g/L妥布霉素和5g/L左氧氟沙星滴眼液点眼清洁睑缘和结膜囊效果更佳，5g/L聚维酮碘和1.6g/L莫西沙星均可作为白内障术前结膜囊冲洗液使用。

METHODS: A total of 216 age-related cataract patients(216 eyes)who were hospitalized for operation in our hospital were enrolled from January 2015 to November 2015, and randomly divided into three groups(72 eyes respectively): Patients in group A were treated with 3g/L tobramycin eye drop; group B were treated with 5g/L levofloxacin eye drop and group C were treated with both two eye drops before surgery. And then each group was randomly divided into two groups: moxifloxacin group(110 eyes)and povidone iodine group(106 eyes). After the routine disinfection and before the formal start of the operation, the conjunctival sac was irrigated with 1.6g/L moxifloxacin or 5g/L povidone iodine respectively. The conjunctival sac and lid margin specimen were collected before admission without any treatment, before and after conjunctival sac irrigation for germicultures and drug susceptibility tests, at the end of operation, conjunctival sac specimen and aqueous humor were collected for germicultures and drug susceptibility tests.

RESULTS:The germiculture positive rate of eyelid margin was 86.6% and the bacterial culture positive rate of conjunctival sac was 25.0% before operation. In groups A, B and C before and after topical antibiotics application, the germiculture positive rate of eyelid margin was 86.1% and 36.1%, 84.7% and 31.9%, 88.9% and 30.6% respectively; the germiculture positive rate of conjunctival sac was 25.0% and 11.1%,26.4% and 11.1%,23.6% and 8.3% respectively. In moxifloxacin group and povidone iodine group before and after conjunctival sac irrigation, the germiculture positive rate of eyelid margin was 33.6% and 10.9%, 32.1% and 10.4% respectively; the germiculture positive rate of conjunctival sac was 10.0% and 0, 10.4% and 0 respectively.

CONCLUSION: Both 5g/L levofloxacin eye drop and 3g/L tobramycin eye drop are effective in diminishing conjunctival sac or eyelid margin bacterium before cataract sugery, the combined effect is better. Both 5g/L PVP-I and 1.6g/L moxifloxacin can be used to irrigate conjunctival sac before cataract surgery.