Study Supports 30-Second Chlorhexidine Protocol for IVI

Clinical Report: Study Supports 30-Second Chlorhexidine Protocol for IVI

Overview

A study presented at the 2026 Retina Society Meeting indicates that a 30-second exposure to aqueous chlorhexidine 0.05% significantly reduces conjunctival bacteria before intravitreal injections (IVIs).

Background

Intravitreal injections are common procedures in retinal practices, necessitating effective antisepsis to prevent infections. Povidone-iodine has been the standard antiseptic.

Data Highlights

Exposure Time	Culture Positivity Pre-Antisepsis	Culture Positivity Post-Antisepsis	CFU Reduction
30 seconds	67.5%	12.5%	84.1%
60 seconds	70%	15%	85.2%
90 seconds	71.4%	14.3%	84.5%

Key Findings

Aqueous chlorhexidine 0.05% reduced conjunctival bacteria significantly within 30 seconds.
Culture positivity decreased from 67.5% to 12.5% in the 30-second group.
Reductions in colony-forming units (CFUs) were similar across all exposure times.
No adverse events, including infectious endophthalmitis or corneal toxicity, were reported.
The findings support a standardized 30-second exposure protocol for aqueous chlorhexidine before IVI.

Clinical Implications

The study indicates that a 30-second exposure to aqueous chlorhexidine may be sufficient for effective antisepsis before IVIs.

Conclusion

The findings support a 30-second chlorhexidine protocol as an alternative to povidone-iodine for antisepsis in intravitreal injections.