Tasmanian Eye Institute, South Launceston, Tasmania, Australia.
Rural Clinical School, University of Tasmania, Burnie, Tasmania, Australia.
Retina. 2018 Oct;38(10):2064-2066. doi: 10.1097/IAE.0000000000001800.
To investigate ocular bacterial count before and after antisepsis with aqueous chlorhexidine (AC) or povidone-iodine (PI) and to assess discomfort with each agent.
Bacterial swabs were taken from participants' eyes before and after antisepsis. These underwent microscopy, culture, and sensitivity testing. Aqueous chlorhexidine drops were administered to left eyes and PI to right eyes. Participants rated their pain (scale 0-10) for each eye but were blinded to the type of drop.
There were 20 participants (17 women, 3 men), and the mean age was 43 years. Pain scores were significantly higher in right (PI) than in left (AC) eyes (mean 7 vs. mean 2, P < 0.001). No abnormalities were detected on specimen microscopy and gram staining. Seven preantisepsis swabs (three left and four right) grew bacteria in culture. Two postantisepsis swabs grew bacteria in primary culture plate (1 after AC and 1 after PI). For an additional one post-PI swab, bacteria were detected in enrichment broth only.
The efficacy of AC and PI are similar, and patient discomfort is lower with AC. Aqueous chlorhexidine is a good alternative to PI for antisepsis before intravitreal injection.
研究用含氯己定（AC）或聚维酮碘（PI）消毒前后眼部的细菌计数，并评估两种药物的不适感。
在消毒前后从参与者的眼睛中采集细菌拭子。这些拭子进行了显微镜检查、培养和药敏试验。左眼滴用 AC，右眼滴用 PI。参与者对每只眼睛的疼痛程度（0-10 分）进行评分，但对滴眼剂的类型不知情。
共有 20 名参与者（17 名女性，3 名男性），平均年龄为 43 岁。右眼（PI）的疼痛评分明显高于左眼（AC）（平均 7 分比平均 2 分，P<0.001）。标本显微镜检查和革兰氏染色未见异常。7 个消毒前拭子（3 个左眼，4 个右眼）在培养中长出细菌。2 个消毒后拭子在初代培养板中长出细菌（1 个在 AC 后，1 个在 PI 后）。对于另外一个 PI 后拭子，仅在增菌肉汤中检测到细菌。
AC 和 PI 的疗效相似，AC 的患者不适感较低。在玻璃体腔内注射前，AC 是 PI 的良好替代品。
