The effect of povidone-iodine 10% plus levofloxacin 0.5% before cataract surgery: a randomized clinical trial

Area of Science:

• Ophthalmology
• Microbiology
• Pharmacology

Background:

• Cataract surgery poses a risk of intraocular infections due to potential microbial contamination of the aqueous humor.
• Current prophylactic measures, such as povidone-iodine (PVI) 10%, aim to minimize this risk, but further improvements are sought.

Purpose of the Study:

• To evaluate the efficacy of a combined povidone-iodine (PVI) 10% and levofloxacin 0.5% solution in reducing aqueous humor contamination one hour prior to cataract surgery.
• To compare the effectiveness of this PVI/Levofloxacin mixture against PVI 10% alone in preventing bacterial presence in the anterior chamber.

Main Methods:

• A prospective study involving 147 patients undergoing cataract surgery.
• Patients were divided into an intervention group (PVI/Levofloxacin mixture) and a control group (PVI 10% alone).
• Aqueous humor samples were collected post-incision and cultured to assess bacterial contamination; statistical analysis used t-test and chi-square tests.

Main Results:

• The intervention group (PVI/Levofloxacin) demonstrated a significantly lower rate of positive cultures (5.3%) compared to the control group (PVI 10% alone) (22.2%).
• The observed reduction in bacterial contamination was statistically significant (P-value = 0.005).

Conclusions:

• The topical application of a mixture containing levofloxacin 0.5% and povidone-iodine 10% is effective in minimizing bacterial contamination of the aqueous humor before cataract surgery.
• This combination therapy presents a promising strategy for enhancing the safety profile of cataract surgery by reducing the risk of postoperative endophthalmitis.