Application of 10% povidone iodine reduces conjunctival bacterial contamination rate in patients undergoing cataract surgery

Eur J Ophthalmol. 2012 Jul-Aug;22(4):541-6. doi: 10.5301/ejo.5000093.


Purpose: To determine the efficacy of 10% povidone iodine (PVI) drops given before cataract extraction in addition to routine irrigation of the conjunctival sac with 1% PVI.

Methods: This prospective, randomized, single-center study at the Department of Ophthalmology, Ludwig-Maximilians-University, Munich, includes 263 eyes of 242 patients undergoing cataract surgery. Patients were randomized to receive 3 drops of 10% PVI into the conjunctival sac (study group) or no PVI drops (control group). All patients underwent periorbital disinfection with 10% PVI followed by irrigation of the conjunctiva with 10 mL of 1% PVI. Specimens were obtained prior to the application of PVI, after antibiotic administration (T1), after irrigation with PVI but before surgery (T2), and at the conclusion of surgery (T3).

Results: After PVI disinfection, the number of positive cultures was significantly reduced in all groups (p<0.0001) from 69%-93% at T1 to 1%-16% at T3. In outpatients, the study group showed significantly fewer positive cultures at the conclusion of surgery compared to the control group (4% vs 16%; p=0.03). Also in inpatients significant fewer positive cultures were found in the study group compared to the control group at T2 (12% vs 28%; p=0.03) and at T3 (1% vs 10%; p=0.03).

Conclusions: Three additional drops of 10% PVI prior to surgery provided additional benefit by reducing the conjunctival bacterial contamination rate even in the setting of preoperative irrigation of the conjunctiva with 1% PVI.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use*
  • Antibiotic Prophylaxis*
  • Bacteria / isolation & purification
  • Bacteriological Techniques
  • Conjunctiva / microbiology*
  • Conjunctivitis, Bacterial / microbiology
  • Conjunctivitis, Bacterial / prevention & control*
  • Disinfection / methods
  • Humans
  • Ophthalmic Solutions
  • Phacoemulsification*
  • Povidone-Iodine / administration & dosage
  • Povidone-Iodine / therapeutic use*
  • Prospective Studies
  • Treatment Outcome


  • Anti-Infective Agents, Local
  • Ophthalmic Solutions
  • Povidone-Iodine