Povidone-Iodine Before Lidocaine Gel Anesthesia Achieves Surface Antisepsis

BACKGROUND AND OBJECTIVE: Viscous lidocaine interferes with ocular surface antisepsis. The current study was designed to evaluate the impact on surface antisepsis of different application sequences with lidocaine gel and povidone-iodine solution. MATERIALS AND METHODS: Blood agar plates inoculated with Staphylococcus epidermidis were treated with varying sequences of 2% lidocaine gel and 5% povidone-iodine solution. The plates were then incubated at 37 C for 24 hours and bacterial growth was determined. RESULTS: Plates on which povidone-iodine was applied alone or prior to lidocaine gel demonstrated no bacterial growth regardless of whether the antiseptic was retained on the plate for 5 seconds or for 30 seconds. There was no statistically significant difference between bacterial growth on plates not treated with povidone-iodine and on plates treated with lidocaine gel alone or prior to povidone-iodine (P = .553 and P = .485, respectively). CONCLUSION: Povidone-iodine effectively reduces bacterial counts when applied alone or prior to lidocaine gel. Lidocaine gel was confirmed to be a barrier to antisepsis when administered prior to povidone-iodine. [Ophthalmic Surg Lasers Imaging 2011;42:346-349.]