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Adriana Caballero, Veronica Elisa Castillo, Margarita Samudio, Norma Farina, Agustin Carron, Herminia Mino de Kaspar, Florentina Laspina, Sonia Abente, M.Rosa Sanabria, Diogenes Cibils; Comparison of the efficacy of 5% or 10% povidone-iodine (PVI) irrigation in combination with moxifloxacin 0.5% as prophylaxis in patients undergoing cataract surgery. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):266.
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© ARVO (1962-2015); The Authors (2016-present)
To compare efficacy of 5% or 10% PVI irrigation in combination with moxifloxacin to decrease bacteria recovery on the conjunctiva before cataract surgery.
After approval by the IRB of Faculty of Medicine of the National University of Asunción, Paraguay, cataract patients were asked to participate in this prospective study from september 2011 to august 2013. All patients received in the eye to be operated topical moxifloxacin 4 times one day before surgery, then were randomly assigned to receive 5% PVI (5% PVI-Group ), or 10% PVI (10% PVI-Group). In both groups the conjunctiva was flush-irrigated with 10ml of the respective PVI concentration. Conjunctival specimen was obtained at 3 timepoints: T0 = no-surgery eye (control), T1 = surgery-eye, both before PVI irrigation, T2 after PVI irrigation, T3 at the end of surgery. All specimens were inoculated into thioglycolate-broth.
A total of 120 patients completed the study: 61 (5%PVI-Group ), 59 (10%PVI-Group). Preoperative use of moxifloxacin (T1) reduced bacteria recovery in 19% (n=82/120, 68.3%) as compared to the eye control T0 (59/120, 49.2%), p=0.009. After PVI irrigation, a strong reduction of conjunctival bacterial recovery was observed in both groups, but difference in positive cultures was not significant comparing 5%PVI-Group (7/61, 11.5%) to 10%PVI-Group (10/59, 16.9% ) (P = 0.39). At the end of surgery, bacteria recovery was similar in both groups (14/61, 23.0% and 14/59, 23.7%, (P = 0,92) . Coagulase-negative Staphylococcus was the most isolated bacteria with similar frequency in both groups. No corneal defect due to PVI occurred in any patients.
The preoperative irrigation with 10% PVI in combination with moxifloxacin showed similar effectiveness to 5% PVI in decreasing bacteria recovery.
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