Povidone-iodine reduces rate of bacterial contamination in anterior chamber

Am J Ophthalmol. 2011;511(1):11-17.

Repeated irrigation with povidone-iodine during cataract surgery significantly minimized bacterial contamination of the anterior chamber, a study found.

The prospective study included 404 eyes of 310 patients. One group of 202 eyes underwent intraoperative irrigation of the operative field with infusion fluid comprising flomoxef sodium. A second group of 202 eyes underwent irrigation with 0.25% povidone-iodine. All patients received topical levofloxacin before surgery. Mean patient age was 65.4 years.

Investigators performed postoperative bacteriologic analysis of ocular surface fluid and anterior chamber fluid. Corneal endothelial cell density was measured preoperatively and 7 days postoperatively.

The bacterial detection rate in ocular surface fluid was 5.5% in eyes irrigated with infusion fluid and 6% in eyes irrigated with povidone-iodine. The between-group difference was statistically insignificant.

The rate of bacterial detection in anterior chamber fluid was 5% in eyes irrigated with infusion fluid and 0% in eyes irrigated with povidone-iodine; the rate was statistically significantly lower in the povidone-iodine group (P = .0017).

Preoperative and postoperative endothelial cell densities were similar in both groups.

No cases of intraoperative posterior capsule damage or postoperative endophthalmitis were reported.