{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T17:19:28Z","timestamp":1788801568248,"version":"build-2803163510"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>A multicenter, nonrandomized, prospective, controlled study was conducted to evaluate, as perioperative prophylactic treatment, the anti-infective effectiveness of 0.66% povidone-iodine eye drops (IODIM\u00ae) against the bacterial flora of the conjunctival surface of patients who undergo cataract surgery. Eye drops containing 0.66% povidone-iodine were applied to the eye undergoing cataract surgery; the untreated contralateral eye was used as control. One hundred and twenty patients set to receive unilateral cataract surgery were enrolled in 5 Italian Ophthalmology Centers and pretreated for three days with 0.66% povidone-iodine eye drops. The contralateral eye, used as control, was left untreated. Conjunctival swabs of both eyes were collected at the baseline visit and after three days of treatment, just before the cataract surgery. A qualitative and quantitative microbiological analysis of bacterial presence was evaluated by means of bacterial culture, followed by identification. Methicillin resistance determination was also performed on staphylococci isolates. Bacterial load before and after treatment of the eye candidate for cataract surgery was evaluated and compared to the untreated eye. A reduction or no regrowth on the culture media of the bacterial load was observed in 100% of the study subjects. A great heterogenicity of bacterial species was found. The 0.66% povidone-iodine eye drops, used for three days prior to cataract surgery, were effective in reducing the conjunctival bacterial load. The 0.66% povidone-iodine eye drops (IODIM\u00ae) might represent a valid perioperative prophylactic antiseptic adjuvant treatment to protect the ocular surface from microbial contamination in preparation of the surgical procedure.<\/jats:p>","DOI":"10.3390\/jcm10102198","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T12:58:07Z","timestamp":1621429087000},"page":"2198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Effectiveness of 0.66% Povidone-Iodine Eye Drops on Ocular Surface Flora before Cataract Surgery: A Nationwide Microbiological Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0143-3601","authenticated-orcid":false,"given":"Rosario","family":"Musumeci","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"},{"name":"MicroMiB Biorepository at the University of Milano-Bicocca, Associated Member of the JRU MIRRI-IT, Via Cadore, 48-20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Troiano","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fatebenefratelli Sacred Family Hospital, 22036 Erba (CO), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2273-6986","authenticated-orcid":false,"given":"Marianna","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"},{"name":"MicroMiB Biorepository at the University of Milano-Bicocca, Associated Member of the JRU MIRRI-IT, Via Cadore, 48-20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Piovella","sequence":"additional","affiliation":[{"name":"Monza Outpatient Microsurgery Center, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Carbonara","sequence":"additional","affiliation":[{"name":"Nursing Home Villa Valeria, 00141 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scipione","family":"Rossi","sequence":"additional","affiliation":[{"name":"San Carlo di Nancy Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-4159","authenticated-orcid":false,"given":"Giovanni","family":"Alessio","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology-Policlinico Hospital of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1987-9794","authenticated-orcid":false,"given":"Luisa","family":"Molteni","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-2034","authenticated-orcid":false,"given":"Claudio Giuseppe","family":"Molteni","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5131-9367","authenticated-orcid":false,"given":"Laura","family":"Saderi","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1600-4474","authenticated-orcid":false,"given":"Giovanni","family":"Sotgiu","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical, Experimental Sciences, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6166-1134","authenticated-orcid":false,"given":"Clementina Elvezia","family":"Cocuzza","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"},{"name":"MicroMiB Biorepository at the University of Milano-Bicocca, Associated Member of the JRU MIRRI-IT, Via Cadore, 48-20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Cao, H., Zhang, L., Li, L., and Lo, S. (2013). Risk factors for acute endophthalmitis following cataract surgery: A systematic review and meta-analysis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0071731"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3341\/kjo.2017.0036","article-title":"Endophthalmitis","volume":"31","author":"Sheu","year":"2017","journal-title":"Korean J. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.joco.2016.05.002","article-title":"Post-cataract surgery endophthalmitis: Brief literature review","volume":"28","author":"Hashemian","year":"2016","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"O\u2019Callaghan, R.J. (2018). The Pathogenesis of Staphylococcus aureus Eye Infections. Pathogens, 7.","DOI":"10.3390\/pathogens7010009"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.2165\/11537950-000000000-00000","article-title":"Prophylaxis of postoperative endophthalmitis following cataract surgery: Current status and future directions","volume":"30","author":"Fintelmann","year":"2010","journal-title":"Drugs"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajoc.2018.02.030","article-title":"Endophthalmitis caused by gram-positive bacteria resistant to vancomycin: Clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes","volume":"10","author":"Shivaramaiah","year":"2018","journal-title":"Am. J. Ophthalmol. Case Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.ajo.2013.12.026","article-title":"Endophthalmitis caused by streptococcal species: Clinical settings, microbiology, management, and outcomes","volume":"157","author":"Kuriyan","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/1469-0691.12118","article-title":"Endophthalmitis","volume":"19","author":"Durand","year":"2013","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_9","first-page":"324","article-title":"Endophthalmitis Prophylaxis for Cataract Surgery","volume":"6","author":"Haripriya","year":"2017","journal-title":"Asia Pac. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/aos.12684","article-title":"Antibiotic prevention of postcataract endophthalmitis: A systematic review and meta-analysis","volume":"93","author":"Kessel","year":"2015","journal-title":"Acta Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s00417-017-3608-y","article-title":"Microbial flora and resistance in ophthalmology: A review","volume":"255","author":"Grzybowski","year":"2017","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_12","first-page":"72","article-title":"More Antisepsis, Less Antibiotics Whenever Possible","volume":"7","author":"Grzybowski","year":"2018","journal-title":"Asia Pac. J. Ophthalmol."},{"key":"ref_13","unstructured":"Barry, P., Cordoves, L., and Gardner, S. (2021, January 15). ESCRS Guidelines on Prevention and Treatment of Endophthalmitis after Cataract Surgery. The European Society of Cataract and Refractive Surgeons. Available online: http:\/\/www.escrs.org\/endophthalmitis\/guidelines\/ENGLISH.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jhin.2016.08.018","article-title":"Acquired resistance to chlorhexidine\u2014is it time to establish an \u2018antiseptic stewardship\u2019 initiative?","volume":"94","author":"Kampf","year":"2016","journal-title":"J. Hosp. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/0002-9610(86)90477-0","article-title":"Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions","volume":"151","author":"Zamora","year":"1986","journal-title":"Am. J. Surg."},{"key":"ref_16","first-page":"509","article-title":"Polyvinyl-pyrrolidone-iodine: An assessment of antibacterial activity","volume":"62","author":"Saggers","year":"1964","journal-title":"J. Hyg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1080\/15569520903080511","article-title":"The toxic effect of different concentrations of povidone iodine on the rabbit\u2019s cornea","volume":"28","author":"Jiang","year":"2009","journal-title":"Cutan. Ocul. Toxicol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1128\/jcm.15.4.635-639.1982","article-title":"Increased bactericidal activity of dilute preparations of povidone-iodine solutions","volume":"15","author":"Berkelman","year":"1982","journal-title":"J. Clin. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0002-9394(14)71640-X","article-title":"Efficacy of topical povidone-iodine during the first week after ophthalmic surgery","volume":"124","author":"Isenberg","year":"1997","journal-title":"Am. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.ajo.2016.10.004","article-title":"Prospective, Randomized Clinical Trial of Povidone-Iodine 1.25% Solution Versus Topical Antibiotics for Treatment of Bacterial Keratitis","volume":"176","author":"Isenberg","year":"2017","journal-title":"Am. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ajo.2010.07.002","article-title":"Reduction of anterior chamber contamination rate after cataract surgery by intraoperative surface irrigation with 0","volume":"151","author":"Shimada","year":"2011","journal-title":"25% povidone-iodine. Am. J. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jcrs.2017.01.007","article-title":"Optimizing the antisepsis protocol: Effectiveness of 3 povidone-iodine 1.0% applications versus a single application of povidone-iodine 5.0%","volume":"43","author":"Silas","year":"2017","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1177\/1120672118802541","article-title":"In vitro bactericidal activity of 0.6% povidone-iodine eye drops formulation","volume":"29","author":"Musumeci","year":"2018","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.1111\/aos.14243","article-title":"In Vitro Antimicrobial Activity of a New Ophthalmic Solution Containing povidone-iodine 0.6% (IODIM\u00ae)","volume":"98","author":"Pinna","year":"2020","journal-title":"Acta Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Reibaldi, M., Avitabile, T., Bandello, F., Longo, A., Bonfiglio, V., Russo, A., Castellino, N., Rejdak, R., Nowomiejska, K., and Toro, M. (2019). The Effectiveness of 0.6% Povidone Iodine Eye Drops in Reducing the Conjunctival Bacterial Load and Needle Contamination in Patients Undergoing Anti-VEGF Intravitreal Injection: A Prospective, Randomized Study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8071031"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"De Vero, L., Boniotti, M.B., Budroni, M., Buzzini, P., Cassanelli, S., Comunian, R., Gullo, M., Lo Grieco, A.F., Mannazzu, I., and Musumeci, R. (2019). Preservation, Characterization and Exploitation of Microbial Biodiversity: The Perspective of the Italian Network of Culture Collections. Microorganisms, 7.","DOI":"10.3390\/microorganisms7120685"},{"key":"ref_27","unstructured":"(2021, March 25). The European Committee on Antimicrobial Susceptibility Testing. Clinical Breakpoints\u2014Bacteria, Version 11.0, 1 January 2021. Available online: http:\/\/www.eucast.org\/clinical_breakpoints\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e1097","DOI":"10.1002\/mbo3.1097","article-title":"Bactericidal and virucidal activity of ethanol and povidone-iodine","volume":"9","author":"Sauerbrei","year":"2020","journal-title":"MicrobiologyOpen"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e919822","DOI":"10.12659\/AJCR.919822","article-title":"Corneal Ulcer treated with 0.66% nanoemulsion povidone-iodine: A case report","volume":"21","author":"Bordin","year":"2020","journal-title":"Am. J. Case Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e928748","DOI":"10.12659\/AJCR.928748","article-title":"Low-Concentration (0.66%) Povidone Iodine Treatment of a Corneal Ulcer in a Rheumatoid Arthritis Patient","volume":"22","author":"Bordin","year":"2021","journal-title":"Am. J. Case Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/10\/2198\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:04:08Z","timestamp":1760162648000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/10\/2198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,19]]},"references-count":30,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["jcm10102198"],"URL":"https:\/\/doi.org\/10.3390\/jcm10102198","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,19]]}}}