Antimicrobial Effect of Ciprofloxacin, Povidone-iodine, and Gentamicin in the Decontamination of Human Donor Globes

Purpose: Clinical research addressing the issue of donor globe decontamination is yet to establish convincing data for the optimal choice of an antimicrobial agent.

Methods: In a donor-globe decontamination study, the antimicrobial effectiveness of a fluoroquinolone antibiotic (ciprofloxacin, 0.3%) was evaluated for the first time and compared with povidone-iodine (P-I, 5%) and gentamicin (0.3%).

Results: Ciprofloxacin and gentamicin were found to be less effective than P-I (p < 0.05) in converting culture-positive donor globes to culture negative. In eliminating coagulase-negative staphylococci that predominated the bacterial spectrum, again P-I scored better than ciprofloxacin (p = 0.003) and gentamicin (p = 0.006). Overall, P-I performed better than the other two in the 3-min decontamination procedure. Decontamination was carried out with the same agent for 15 min to assess the effect of duration of decontamination on the antimicrobial activity of P-I. With time, there was no significant increase in the antimicrobial efficacy of the agent except for Corynebacterium species.

Conclusion: P-I continues to be the preferred agent for decontaminating donor globes. Whereas a contact of 3-min duration between P-I and donor globe remains satisfactory in decontamination procedures, corneal tolerance of this procedure needs investigation.