In vivo assessment of antimicrobial activity and toxicity of repeated 1% povidone-iodine applications versus a single 5% povidone-iodine application
David Teren, Gil Neuman, Adi Abulafia, Evgeny Gelman, Elishai Assayag, Abeer Hajj, Orna Shwartz, David Zadok- Sensory Systems
- Ophthalmology
- Surgery
Purpose:
To demonstrate the non-inferiority in antimicrobial effectiveness of thrice-repeated applications of 1% povidone-iodine (PI) compared to a single application of 5% PI on the ocular surface in vivo and to evaluate potential toxicity of PI to the corneal epithelium.
Setting:
Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel.
Design:
Prospective randomized, double-blind study.
Methods:
Patients randomly received either a single application of 5% PI or repeated irrigations of 1% PI on the ocular surface before surgery. Bacterial colony counts were quantitatively analyzed by taking standardized conjunctival swabs before and after irrigation, and differences in bacterial colony counts were compared between the 2 groups. The presence of superficial punctate keratopathy was evaluated in all patients by the National Eye Institute grading system.
Results:
The study comprised 102 eyes of 102 patients. Both 1% and 5% PI yielded a marked decrease in bacterial colonies compared to pre-application (
Conclusion:
Preoperative repeated applications of 1% PI effectively eradicated ocular surface bacteria equal to that of 5% PI with less deleterious impact on the corneal epithelium. Our findings suggest that 1% PI may be a promising alternative to 5% PI.