title: Effectiveness of timely intraoperative iodine irrigation during cataract surgery.
abstract: OBJECTIVE
  To determine the antiseptic efficacy of timely intraoperative iodine irrigation during cataract surgery.
  
  
  METHODS
  A total of 198 eyes of 99 cataract surgery patients were studied. The eyes were randomly assigned to treatment with or without timely intraoperative iodine irrigation of the surgical field with an iodine compound equivalent to 0.33 % povidone-iodine. In eyes in the timely intraoperative iodine irrigation group, the ocular surface was irrigated twice intraoperatively-before the initial incision and before insertion of the intraocular lens (IOL). The efficacy of the antiseptic treatment was evaluated by culture tests using scrapings of the surface of the sclerocornea and conjunctiva to the left of the incision and by broad-range real-time PCR for bacterial 16S ribosomal DNA using scrapings from the right side of the incision.
  
  
  RESULTS
  Following intraoperative application of the iodine, bacteria were not detected in cultures of the samples. For the control eyes without timely iodine irrigation, cultures of samples from five and two eyes were positive before the initial incision and before IOL insertion, respectively. The bacterial DNA copy number before the initial incision was 1.7 ± 0.5 × 103, which was significantly lower than that of the control eyes (1.7 ± 0.6 × 104). For both groups of eyes, the bacterial DNA copy number was significantly lower before the IOL insertion depending on the time course. When the antiseptic effect of the iodine irrigation and time course on bacterial DNA copy number was analyzed using generalized mixed linear regression, both were found to be significantly effective. No significant intraoperative epithelial defect was observed. The postoperative corneal endothelial cell count did not differ significantly between the two groups of eyes.
  
  
  CONCLUSIONS
  Timely iodine irrigation can serve as a simple and useful adjunctive disinfection step in cataract surgery.
authors.affiliation: Nojima Hospital, 2714-1 Sesaki-machi, Kurayoshi, Tottori, 682-0863, Japan. matsuura.kzk@gmail.com.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Miyazaki
authors.affiliation: Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Sasaki
authors.affiliation: Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Yakura
authors.affiliation: Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: The Research Foundation for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Sakamoto
mesh_terms: D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D002387:Cataract Extraction; D015818:Eye Infections, Bacterial / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D011206:Povidone-Iodine / Q000008:administration & dosage*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D007507:Therapeutic Irrigation
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine
keywords: Cataract surgery; Endophthalmitis; Intraoperative disinfection; Iodine irrigation