Infections after blepharoplasty are uncommon with or without the use of an antibiotic ointment. However, if infections occur, be suspicious of community-acquired methicillin-resistant Staphylococcus aureus (MRSA), said Mark A. Alford, MD.
He made those conclusions based on his prospective, cohort, observational study on the topic.1 When antibiotic ointments are used, the infection rate after blepharoplasty is extremely low, at only 0.2%.
However, there are always concerns about contact sensitivity, bacterial resistance, and cost, explained Dr. Alford, North Texas Ophthalmic Plastic Surgery, Fort Worth, TX.
Though patients with an ointment allergy may fare fine in the long term, the short-term effects on appearance can be concerning, he said.
Dr. Alford’s study compared two similar consecutive groups undergoing upper eyelid blepharoplasty.
In the first group, 384 patients who had blepharoplasty between 2011 and 2013 used bacitracin twice a day for a week. The average patient age was 69.2 years old, with a range of 38 to 87 years old. Patients were excluded if they had an obvious allergy or systemic antibiotic use within a week of surgery.
The second group included 158 patients who used lubricant eye ointment (Refresh PM, Allergan) twice a day for a week. The average patient age was 69.3 years old, with a range of 30 to 96 years old. Patients were excluded if they had an allergy to previous topical ointments or if they used systemic antibiotics.
All surgeries were performed by Dr. Alford at two surgical centers. There was an identical surgical technique and surgical prep in all cases. Preoperative antibiotics were not used. All patients were seen at a week after surgery.