{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:48:56Z","timestamp":1785779336806,"version":"3.56.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ocular Pharmacology and Therapeutics"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>\n                      To evaluate\n                      <jats:italic toggle=\"yes\">in\u00a0vivo<\/jats:italic>\n                      efficacy of different topical strategies administered before intravitreal injections (IVIs) in reducing conjunctival microbial load compared with standard preoperative disinfection with 5% povidone-iodine (PI-5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective randomized comparative study was conducted between January and July 2025 at a tertiary referral ophthalmology center. Patients scheduled for IVIs were randomly assigned to 4 groups: 0.1% Polyquaternium-133, 0.6% povidone-iodine, 0.02% chlorhexidine digluconate, or no preoperative drops [control group (CG)]. Antiseptic eye drops were administered 3 times daily for 3 days before the procedure. Conjunctival swabs were collected at baseline (T0), on the day of injection before standard disinfection (T1), and 3 minutes after PI-5% application (T2). Microbial load was assessed by colony-forming unit (CFU) count, and microorganisms were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 205 patients were enrolled. In the CG, no significant difference was observed between T0 and T1, while PI-5% produced a significant CFU reduction at T2. Preoperative treatment with 0.6% povidone-iodine or 0.02% chlorhexidine digluconate did not significantly reduce CFU counts at T1. In contrast, 0.1% Polyquaternium-133 resulted in a significant reduction in bacterial load between T0 and T1, with a further decrease after PI-5%. Qualitative analysis showed selective effects of antiseptics on conjunctival microbial composition, with Polyquaternium-133 demonstrating marked activity against predominant species, including\n                      <jats:italic toggle=\"yes\">Corynebacterium macginleyi<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Complete conjunctival sterility was not achieved with any regimen. However, 0.1% Polyquaternium-133 significantly reduced conjunctival bacterial load and showed a complementary effect when combined with standard PI-5% disinfection, suggesting potential clinical benefit in prophylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10807683261472086","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:25:14Z","timestamp":1785475514000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["<i>In Vivo<\/i>\n                    Evaluation of Preoperative Topical Strategies in Reducing Conjunctival Microbial Load before Intravitreal Injections"],"prefix":"10.1177","author":[{"given":"Carlo","family":"Cagini","sequence":"first","affiliation":[{"name":"Department of Medicine Surgical, Section of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5047-4745","authenticated-orcid":false,"given":"Nicola","family":"De Santi","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgical, Section of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Solito","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgical, Section of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosaria","family":"Giugliano","sequence":"additional","affiliation":[{"name":"Department of Medicine Surgical, Section of Ophthalmology, S. 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Maria della Misericordia Hospital, University of Perugia, Perugia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Eslami Varzaneh","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Microbiology Unit, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Pietrella","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Microbiology Unit, S. 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