PAIN AND ANTISEPSIS AFTER OCULAR ADMINISTRATION OF POVIDONE-IODINE VERSUS CHLORHEXIDINE

Area of Science:

• Ophthalmology
• Microbiology
• Infectious Disease

Background:

• Ocular antisepsis is crucial before intraocular procedures to prevent infection.
• Povidone-iodine (PI) is a common antiseptic, but can cause ocular discomfort.
• Aqueous chlorhexidine (AC) is an alternative antiseptic agent requiring efficacy and safety evaluation.

Purpose of the Study:

• To compare the bacterial counts on the ocular surface before and after antisepsis using AC versus PI.
• To evaluate and compare the level of patient-reported discomfort associated with AC and PI ocular antisepsis.
• To assess the suitability of AC as an alternative to PI for pre-intravitreal injection antisepsis.

Main Methods:

• Prospective study involving 20 participants undergoing ocular antisepsis.
• Bacterial swabs collected from eyes pre- and post-antisepsis for microscopy, culture, and sensitivity testing.
• Participants received AC in the left eye and PI in the right eye, blinded to the agent, and reported pain on a 0-10 scale.

Main Results:

• No significant bacterial growth observed on microscopy or Gram staining.
• Seven pre-antisepsis swabs (3 left, 4 right) showed bacterial growth.
• Two post-antisepsis swabs grew bacteria (1 AC, 1 PI); one additional PI swab showed growth in enrichment broth only.
• Significantly lower pain scores reported for AC (mean 2) compared to PI (mean 7) (P < 0.001).

Conclusions:

• Both aqueous chlorhexidine and povidone-iodine demonstrate comparable efficacy in reducing ocular bacterial counts.
• Aqueous chlorhexidine is associated with significantly lower patient-reported discomfort than povidone-iodine.
• Aqueous chlorhexidine presents a favorable alternative to povidone-iodine for ocular antisepsis prior to intravitreal injections.