The Effects of Low Viscosity Preservative-Free Chloroprocaine Ophthalmic Gel 3% versus BAK-Containing Tetracaine 0.5% on the Bactericidal Action of Povidone-Iodine.

Purpose: To evaluate if chloroprocaine ophthalmic gel 3% acts as a barrier to the bactericidal actions of povidone-iodine (PVI) which has been seen in other higher viscosity gel anesthetics.

Methods: This was a single site, prospective, randomized, patient-masked study evaluating the effects of preservative-free chloroprocaine ophthalmic gel 3% (IHEEZO, Harrow, Nashville, TN) compared with tetracaine ophthalmic solution 0.5% and their effects on the bactericidal action of povidone-iodine 5%. The study comprised 82 patients who had both eyes cultured before and after application of randomized treatment and povidone-iodine.

Results: In terms of mean percent reduction in colony forming units, chloroprocaine with povidone-iodine was non-inferior to tetracaine with povidone-iodine, with a higher mean percent reduction in colony forming units in the chloroprocaine group (change [∆] = -7.2; 90% CI, -13.56 to 3.28).

Conclusion: Data collected in this study suggest that preservative-free chloroprocaine ophthalmic gel 3% does not act as a barrier to the bactericidal actions of povidone-iodine 5% and that the reduction in CFU from PVI is similar when compared with tetracaine 0.5% ophthalmic solution with PVI.