Fewer positive conjunctival cultures found when fornices are irrigated

Irrigating the fornices with 5% povidone-iodine is associated with significantly fewer positive conjunctival cultures at the time of surgery compared with the application of two drops on the conjunctiva, according to a study.

Herminia Miño de Kaspar, PhD, and colleagues at Ludwig-Maximilians University in Munich prospectively studied 200 eyes that underwent anterior segment intraocular surgery. Patients were divided into two groups; 108 eyes were in the control group, and 92 were in the study group. After cancelled cases, 95 cases remained in the control group and 79 in the study group. In 2 patients, both eyes were assigned to the study group in one patient and both eyes were assigned to the control group in the other patient. For purposes of this study, results from only one eye in each of these patients was included. The mean age for both groups was 70 years.

All patients received topical ofloxacin and a povidone-iodine scrub of the periorbital area. Eyes in the control group received two drops of povidone-iodine on the conjunctiva preoperatively, while the study eyes had irrigation of the fornices with 10 mL of povidone-iodine administered. Cultures were obtained at four separate times before and after the surgery.

Of eyes in the irrigation study, 20 of 78 eyes had positive conjunctival cultures before surgery compared with 40 of 94 eyes in the control group. After surgery, 14 of 78 eyes in the study group and 30 of 94 eyes in the control group had positive cultures.

“Given the powerful antiseptic effect of povidone-iodine with minimal or no toxic effect to the ocular surface and its low cost, we recommend irrigating the conjunctiva and fornices with 5% povidone-iodine before ophthalmic surgery,” the group said in the February issue of Archives of Ophthalmology.