A prospective study demonstrating the effect of 5% povidone-iodine application for anterior segment intraocular surgery in Paraguay

Purpose: To determine the conjunctival bacterial flora in cataract surgery patients and the effect of presurgical irrigation with 5% povidone-iodine solution. Methods: Three samples from the inferior conjunctival fornix of the eye to be operated were obtained at baseline before washing (T-0) with 10 ml 5% povidone-iodine solution, immediately after washing (T-1), and upon completion of surgery (T-2). Bacteria from the samples were inoculated in blood agar, chocolate agar, and thioglycolate broth. Results: A total of 221 patients (n=224 eyes) with a mean age of 67 +/- 13 years were included in the study. Bacteria from the (T-0) samples were successfully grown in 73.2% of the thioglycolate agars, 21.0% of the blood agars, and 19.2% of the chocolate agars. Compared with T 1 samples, the use of povidone-iodine wash translated into a 60.8% reduction (from 73.2% to 12.5%) in colonization of the conjunctiva (p<0.001), while no significant difference was found between the T 1 and T 2 samples. Conclusion: Conjunctival irrigation with a 5% povidone-iodine solution effectively reduces conjunctival flora and is therefore strongly recommended as a means of preventing postsurgical endophthalmitis following cataract surgery.