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Y. Yactayo Miranda, L. P. Quiroga, F. Laspina, M. Samudio, I. Ojeda, J. Stanley, D. Cibils, V. C. Lansingh, M. Río, H. Mino de Kaspar; Reduction of Conjunctival Flora by Presurgical Irrigation With Povidone-Iodine in Cataract Surgery Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1057.
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Postsurgery endophthalmitis is a rare although devastating complication of cataract surgery. While antibiotics are frequently prescribed for postsurgery prophylaxis to prevent its occurrence, circumstances exist that preclude such use, and another means of reducing the possibility of endophthalmitis is required. We therefore undertook a prospective study to determine the composition of the conjunctival flora in cataract surgery patients and the effect of presurgical washing with a 5% povidone-iodine solution.
Patients of all ages who underwent extracapsular cataract surgery in our service between November 2005 and July 2006 were eligible for participation. Three samples were taken from the conjunctival fornices of the operative eye before washing with 10ml of 5% povidone-iodine (T0), immediately after washing (T1), and after surgery (T2). Cultures were grown in blood agar, chocolate agar (under aerobic and anaerobic conditions), and thioglycolate.
A total of 224 patients with a mean age of 67 ± 13 years were included in the study. Bacteria from the T0 samples were successfully cultured in 70% of the thioglycolate, 21% of blood, and 19.2% of the chocolate agar plates. A comparison of the results from the T1 and T0 samples demonstrated that use of the povidone-iodine wash reduced colonization of the conjunctiva by 57.5% (from 70% to 12.5%; P < .001), while no significant difference was found between the T1 and T2 sample results.
Presurgical conjunctival washing with a 5% povidone-iodine solution significantly reduces conjunctival flora and is therefore strongly recommended for prevention of postsurgical endophthalmitis following cataract surgery.
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