alexa Comparison of the efficacy of povidone-iodine 1.0\%, 5.0\%, and 10.0\% irrigation combined with topical levofloxacin 0.3\% as preoperative prophylaxis in cataract surgery.


Clinical Microbiology: Open Access

Author(s): Li B, Nentwich MM, Hoffmann LE, Haritoglou C, Kook D,

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Abstract PURPOSE: To compare the efficacy of povidone-iodine 1.0\%, 5.0\%, and 10.0\% in combination with topical levofloxacin 0.3\% in reducing the preoperative conjunctival bacterial load before cataract surgery. SETTING: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. DESIGN: Randomized clinical trial. METHODS: This study enrolled patients scheduled for cataract surgery between July 2010 and January 2011. All patients received topical levofloxacin 0.3\% 4 times on the preoperative day and were randomly assigned to these study groups: Group 1 (povidone-iodine 1.0\%), Group 2 (povidone-iodine 5.0\%), and Group 3 (povidone-iodine 10.0\%). In all groups, the conjunctiva was flush irrigated with 10 mL of povidone-iodine of the respective concentration. Conjunctival specimens were obtained at 4 timepoints: baseline (no-surgery eye), before povidone-iodine irrigation, after povidone-iodine irrigation, and at the end of surgery. All specimens were inoculated onto blood and chocolate agars and into thioglycolate broth. RESULTS: The study was completed by 271 patients. In the control smear (no-surgery eye), no significant difference in positive cultures was found. After 10 mL povidone-iodine irrigation, a considerable reduction in the conjunctival bacterial load occurred in all groups. The difference in positive cultures was statistically significant between Group 1 and Group 3 (P=.024) and between Group 2 and Group 3 (P=.029). Coagulase-negative Staphylococcus was the most commonly isolated bacteria in all groups. CONCLUSION: Povidone-iodine 10.0\% was more effective than povidone-iodine 1.0\% and 5.0\% in decreasing the conjunctival bacterial load before surgery. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved. This article was published in J Cataract Refract Surg and referenced in Clinical Microbiology: Open Access

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