title: 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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Povidone-iodine 10.0% was more effective than povidone-iodine 1.0% and 5.0% in decreasing the conjunctival bacterial load before surgery.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. bing-li-2007@163.com
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Martin M
authors.initials: MM
authors.lastname: Nentwich
authors.forename: Larissa E
authors.initials: LE
authors.lastname: Hoffmann
authors.forename: Christos
authors.initials: C
authors.lastname: Haritoglou
authors.forename: Daniel
authors.initials: D
authors.lastname: Kook
authors.forename: Anselm
authors.initials: A
authors.lastname: Kampik
authors.forename: Minjie
authors.initials: M
authors.lastname: Sheng
authors.forename: Herminia
authors.initials: H
authors.lastname: Miño de Kaspar
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification; D058491:Bacterial Load; D001431:Bacteriological Techniques; D002387:Cataract Extraction; D003228:Conjunctiva / Q000382:microbiology; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000517:prevention & control; D005260:Female; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use*; D008297:Male; D011206:Povidone-Iodine / Q000627:therapeutic use*; D011446:Prospective Studies; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D064704:Levofloxacin; D011206:Povidone-Iodine