Effect of Povidone-Iodine Irrigation on the Preoperative Chemical Preparation of the Eye

Abstract

Preoperative eyes which had been treated with gentamicin for one-half day were subjected to one of two povidone-iodine (PI) preparations. The control eye was prepared using a previously described 5% PI one-drop technique, while the paired eye was irrigated with a 0.02% PI solution. Aerobic and anaerobic bacterial cultures were taken of each eye before and after PI applications. Statistical analysis of the data indicates that both techniques were equally effective in reducing surface colonization of the anaerobic cocci and bacilli, the viridans streptococci and micrococci. Both methods were also equally ineffective in reducing the numbers of coagulase-negative staphylococci from the surface of the eye. With the apparent emergence of gentamicin-resistant coagulase-negative staphylococci the potential for staphylococcal endophthalmitis is increasing.

Comparison of 5% povidone-iodine solution against 1% povidone-iodine solution in preoperative cataract surgery antisepsis: a prospective randomised double blind study

“…The type of bacteria isolated were consistent with the bacterial flora found in previous studies. [9][10][11][12] None of these either before or after irrigation showed a significant difference between the treatment groups. Twenty six of the 100 cultures were "sterile" (yielded no cultured organism) before irrigation, and 22 of these were also "sterile" following irrigation.…”

“…Povidone-iodine stock solution is 10%, comprising 90% water, 8.5% povidone-iodine, 1% available iodine, and iodide. 3 Previous studies have shown that 5% povidone-iodine effectively decreases the bacterial flora of the ocular surface and adnexae, [9][10][11][12] and thus theoretically decreases the risk of endophthalmitis, while other large studies have demonstrated 5% povidone-iodine to directly decrease the incidence of endophthalmitis. 1 13 More dilute concentrations have been studied in vivo in dogs' eyes where 0.2% povidone-iodine was shown to be equally as bactericidal as 1% and 5% povidone-iodine.…”

“…14 In human eyes, in a small study, 0.02% povidone-iodine irrigation has been found to be equally bactericidal compared to 5% povidone-iodine drops. 9 There has been no study to compare more dilute concentrations of povidone-iodine with 5% povidone-iodine in the human eye while controlling other variables such as method or length of irrigation. We therefore conducted a prospective randomised double blind comparative study of the effect of 5% povidone-iodine against 1% povidone-iodine on the bacterial flora of the human conjunctiva, using an identical and clinically relevant method of application, to see if the increased bactericidal effect of lower concentrations seen in vitro was reproducible in vivo.…”

Bakterielles Kontaminationsrisiko nach Povidon-Iod-Desinfektion in der Kataraktchirurgie

“…Bis anhin wurde bei den präoperativen Desinfektionsstudien häufig die Keimzahl mittels Bindehautabstrichen verglichen [2,7,8,12,14,16,18,22]. Die Methode mittels mikrobiologischer Analyse der Schnittmesser ist erst in neuerer Zeit aufgetaucht.…”

“…Für die Haut ist Povidon-Iod in einer 8 -10 % Lösung kommerziell erhältlich. Weit verbreitet in der Ophthalmochirurgie ist die kommerziell erhältliche 5 % topische Tropflösung (5 % Betadine Sterile Ophthalmic Prep Solution; Alcon Laboratories, Inc, Fort Worth, Texas, USA) [10,28], obwohl Verdün-nungen bis 0,02 % ähnlich stark desinfizierende Wirkungen zeigen [14,16]. Während bei früheren Studien die Keimzahl meistens mittels konjunktivaler Abstriche verglichen wurde, analysierten neuere Studien die Kontaminationsrate intraoperativ benutzter Schnittmesser.…”