The efficacy of 5% povidone-iodine for 3 minutes prior to cataract surgery

Eur J Ophthalmol. 2009 Jul-Aug;19(4):560-4. doi: 10.1177/112067210901900407.


Purpose: To evaluate the efficacy of 3 minutes of 5% povidone-iodine for skin and conjunctival antisepsis prior to cataract surgery as recommended by the European Society of Cataract and Refractive Surgeons.

Methods: A prospective controlled study of 54 patients undergoing unilateral cataract surgery by phacoemulsification was undertaken. The eye undergoing surgery was prepared with 5% povidone-iodine for 3 minutes. The other eye served as control. Swabs were taken from both eyes prior to application of 5% povidone-iodine and 3 minutes after. Proportion of culture-positive swabs, mean number of species, and growth of isolates on culture were compared at different times and between the two groups.

Results: Coagulase-negative Staphylococcus (CoNS) was the main species isolated from culture-positive swabs. Use of 5% povidone-iodine for 3 minutes resulted in a statistically significant reduction in proportion of culture-positive swabs (87% vs 30%, p<0.001), mean number of species (0.96-/+0.47 vs 0.30-/+0.46, p<0.001), and growth of CoNS (heavy: 30% vs 0%, moderate: 23% vs 6%, light: 47% vs 94%, p=0.004). No such changes were observed in the control group.

Conclusions: Use of 5% povidone-iodine for 3 minutes prior to cataract surgery achieves a significant reduction in organisms such as CoNS from lid and conjunctival flora.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use*
  • Antibiotic Prophylaxis*
  • Bacteria / isolation & purification
  • Conjunctiva / drug effects*
  • Conjunctiva / microbiology
  • Endophthalmitis / microbiology
  • Endophthalmitis / prevention & control
  • Eye Infections / microbiology
  • Eye Infections / prevention & control
  • Eyelids / drug effects*
  • Eyelids / microbiology
  • Humans
  • Phacoemulsification*
  • Povidone-Iodine / therapeutic use*
  • Prospective Studies
  • Time Factors
  • Treatment Outcome


  • Anti-Infective Agents, Local
  • Povidone-Iodine