The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 1, January/February 2017 Original Study - Clinical

Optimal Duration for the Use of 0.5% Levofloxacin Eye Drops Before Vitreoretinal Surgery

Li, Xiaoxin; Liang, Xiaoling; Tang, Luosheng; Zhang, Junjun; Shen, Lijun; Su, Guanfang; Li, Xiaorong

Author Information

From the *Peking University People’s Hospital, Beijing; †Yat-Sen Ophthalmic Center of Sun Yat-Sen University, Guangzhou; ‡Xiangya Second Hospital of Central South University, Changsha; §Sichuan University Huaxi Hospital, Chengdu; ¶Eye Hospital of Wenzhou Medical University, Wenzhou; Second Hospital of Jilin University Eyehospital, Changchun; and **Eye Center of Tianjin Medical University, Tianjin, China.


Reprints: Xiaoxin Li, MD, Department of Ophthalmology, Peking University People’s Hospital, No. 11 Xizhimen South Avenue, Xicheng District, Beijing 100044, China. E-Mail:



Purpose: To investigate various regimens of prophylactic antibiotic therapy for vitreoretinal surgery.


Design: This study compared different prophylactic therapies with 0.5% levofloxacin eye drops.


Methods: Two hundred nine patients from 7 hospitals scheduled to undergo vitreoretinal surgery were randomized into 3 groups to receive 0.5% levofloxacin eye drops for 1 day (6 times/d), 2 days (3 times/d), or 3 days (3 times/d) before surgery (groups 1D, 2D, and 3D, respectively). All patients received 3 applications of levofloxacin eye drops at 15-minute intervals beginning 1 hour before surgery and conjunctival sac disinfection with 5.0% povidone-iodine 15 minutes before surgery. conjunctival swabs were cultured before levofloxacin therapy (T0), on the morning of surgery (T1), after povidone-iodine disinfection (T2), immediately after surgery (T3), 1 day postoperatively (T4), and 1 week postoperatively (T5).


Results: The positive bacterial culture rates in groups 1D, 2D, and 3D fell, respectively, from 37.33%, 30.77%, and 31.88% at T0 to 10.67%, 12.31%, and 11.59% at T1 and 1.33%, 0%, and 0% at T2. At each time point (T0–T5), there were no significant differences among the groups in positive bacterial culture rate. The bacterial eradication rates in groups 1D, 2D, and 3D were, respectively, 100%, 94.74%, and 90.00% at T1 (after levofloxacin) and 100% in all groups at T2 (after povidone-iodine).


Conclusions: The efficacy of levofloxacin in preventing postoperative infection was similar in the 3 treatment groups. it is recommended that 0.5% levofloxacin be used for only 1 day before vitreoretinal surgery (6 times/d) to minimize the use of prophylactic antibiotics.

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