THE EFFECT OF POVIDONE-IODINE SOLUTION APPLIED AT THE CONCLUSION OF OPHTHALMIC SURGERY

PURPOSE: Povidone-iodine 5% solution decreases the incidence of postop erative endophthalmitis is when used on the eye for preoperative prepa ration. We sought to determine whether it also minimized conjunctival bacterial flora immediately after surgery by preventing bacteria prese nt on the surface of the eye from entering surgical wounds. METHODS: I n 42 eyes of 40 patients, at the conclusion of surgery, on an alternat ing basis, each patient received either a drop of a broad-spectrum ant ibiotic solution (polymyxin B sulfate-neomycin sulfate gramicidin) or a 5% povidone-iodine solution in the operated on eye. Bacterial cultur es were taken before and after surgery and 24 hours later. The 38 unop erared on eyes in the unilateral cases served as control eyes. RESULTS : Relative to the control group, povidone-iodine was effective in prev enting an increase in the number of colony-forming units (P = .035), w hile the antibiotic was not. At 24 hours after surgery, the species co unt was lower in the eyes receiving povidone-iodine than in the antibi otic-treated eyes (P = .034) and was increased in the antibiotic group since the completion of surgery (P = .013), but was lower in the povi done-iodine and antibiotic groups than in the control eyes for both gr oups (P < .01). CONCLUSIONS: Povidone-iodine 5% solution applied to th e eye at the conclusion of surgery was more effective at minimizing th e number of colony-forming units and species for the first postopere a tive day than was a broad-spectrum antibiotic. While not true for the antibiotic, the antimicrobial effect of povidone-iodine lasted for at least 24 hours after the completion of surgery.