The effect of topical povidone–iodine, intraocular vancomycin, or both on aqueou humor culture at the time of cataract urgery

PURPOE: To invetigate whether the ue of topical povidone–iodine before urgery, the addition of vancomycin to the irrigating olution during phacoemulification, or both reduce the frequency of poitive intraocular culture at the end of urgery. METHOD: A two-part, clinical tudy wa performed. In the preliminary tudy, intracameral antibiotic concentration were meaured immediately after urgery (in 11 eye) and 2 hour after urgery (in 11 eye) in patient treated with vancomycin. In the primary tudy, 4001 patient were divided into four group compoed of 100 eye each. The firt and the econd group received vancomycin (20 μg/ml) in the irrigating fluid. The third and the fourth group received irrigating fluid only without antibiotic. The firt and third group received a topical 5% povidone–iodine olution 10 and 5 minute before urgery; a topical placebo olution wa ued in the econd and the fourth group. All patient in the primary tudy underwent anterior chamber apiration after urgery, and culturing wa performed 2 hour later. Identification and quantification of poitive culture in thioglycolate broth and chocolate agar were performed. REULT: In the preliminary tudy, the half-life of intraocular vancomycin wa le than 2 hour. In the primary tudy, intraocular apirate yielded poitive culture in two (2%), five (5%), 11 (11%), and 13 (13%) pecimen from the firt, econd, third, and fourth group, repectively. CONCLUION: We found a lower rate of poitive culture in the group that received vancomycin in the irrigating fluid; 2 hour of contact between the antibiotic olution and bacteria produced reult that reached tatitical ignificance (P = 0.032).