• Bing Li, Martin M Nentwich, Larissa E Hoffmann, Christos Haritoglou, Daniel Kook, Anselm Kampik, Minjie Sheng, and Herminia Miño de Kaspar.
• Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. bing-li-2007@163.com
• J Cataract Refract Surg. 2013 Jul 1; 39 (7): 994-1001.

PurposeTo 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.SettingDepartment of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.DesignRandomized clinical trial.MethodsThis 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.ResultsThe 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.ConclusionPovidone-iodine 10.0% was more effective than povidone-iodine 1.0% and 5.0% in decreasing the conjunctival bacterial load before surgery.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned.Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

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