Purpose: To investigate the reduction of the ocular surface bacterial load induced by two commercially available ophthalmic antiseptic formulations, povidone-iodine (PVI) 0.6% and chlorexidine (CLX) 0.02%, before ocular surgery. Design: Randomized controlled trial. Methods: Seventy adult patients, undergoing intraocular surgery (phacoemulsification), were randomized to receive in the index eye PVI (group A) QID for 3 days or CLX (group B)" QID for 3 days before surgery. The untreated eye was used as control. A conjunctival swab was taken in both eyes before (T0) and after (T1) therapy. Microbial DNA was quantified with real-time PCR analysis. The Mick algorithm was used to compare the abundance of each genus/genera against the distribution of abundances from the reference. At T1, patients filled a questionnaire to evaluate therapy-induced symptoms. Primary outcome was the reduction of bacterial DNA at T1 (microbial load), vs. control arm, expressed as mean number of real-time PCR cycle times (CT). Secondary outcomes were taxonomic composition, differential abundance, and therapy-induced ocular symptoms. Results: The difference T0-T1 in CT was significant in group B, but not in group A (mean [95% CI], 0.99[0.33] vs. 0.26[0.15], p<0.001, and 0.65[0.3] vs. 0.45[0.41], p=0.09, respectively). The taxonomic composition, alpha and beta diversity remained consistent at all time-points in both groups. The rate of patients reporting therapy-induced ocular symptoms and the mean discomfort grade were greater in group A than in group B (97% vs 26% and 4.97±2.48 vs 0.66±1.53, respectibely). Conclusions: Compared to PVI 0.6%, CLX 0.02% induced a greater reduction of ocular surface bacterial load, with no significant alterations of the taxonomic composition. Moreover, CLX was better tolerated than PVI.

Topical antiseptics in minimizing ocular surface bacterial load before ophthalmic surgery: a randomized controlled trial

Romano, Mario;
2024-01-01

Abstract

Purpose: To investigate the reduction of the ocular surface bacterial load induced by two commercially available ophthalmic antiseptic formulations, povidone-iodine (PVI) 0.6% and chlorexidine (CLX) 0.02%, before ocular surgery. Design: Randomized controlled trial. Methods: Seventy adult patients, undergoing intraocular surgery (phacoemulsification), were randomized to receive in the index eye PVI (group A) QID for 3 days or CLX (group B)" QID for 3 days before surgery. The untreated eye was used as control. A conjunctival swab was taken in both eyes before (T0) and after (T1) therapy. Microbial DNA was quantified with real-time PCR analysis. The Mick algorithm was used to compare the abundance of each genus/genera against the distribution of abundances from the reference. At T1, patients filled a questionnaire to evaluate therapy-induced symptoms. Primary outcome was the reduction of bacterial DNA at T1 (microbial load), vs. control arm, expressed as mean number of real-time PCR cycle times (CT). Secondary outcomes were taxonomic composition, differential abundance, and therapy-induced ocular symptoms. Results: The difference T0-T1 in CT was significant in group B, but not in group A (mean [95% CI], 0.99[0.33] vs. 0.26[0.15], p<0.001, and 0.65[0.3] vs. 0.45[0.41], p=0.09, respectively). The taxonomic composition, alpha and beta diversity remained consistent at all time-points in both groups. The rate of patients reporting therapy-induced ocular symptoms and the mean discomfort grade were greater in group A than in group B (97% vs 26% and 4.97±2.48 vs 0.66±1.53, respectibely). Conclusions: Compared to PVI 0.6%, CLX 0.02% induced a greater reduction of ocular surface bacterial load, with no significant alterations of the taxonomic composition. Moreover, CLX was better tolerated than PVI.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11699/80183
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