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Low-concentration povidone-iodine for the prevention of intraocular infections in ophthalmic surgery

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CURRENT OPINION IN OPHTHALMOLOGY
卷 33, 期 1, 页码 28-34

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICU.0000000000000817

关键词

antisepsis; endophthalmitis; povidone-iodine

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Endophthalmitis following intraocular surgery is rare with current antiseptic techniques, but challenges such as increased multidrug-resistant bacterial endophthalmitis and low rate of endophthalmitis caused by typical bacteria still exist. Recent findings show that povidone-iodine is widely available and repetitively applying diluted povidone-iodine can effectively sterilize the ocular surface.
Purpose of review Endophthamitis following intraocular surgery is rare using current antiseptic techniques, such as single application of 5% povidone-iodine to the ocular surface and adjuvant topical or intracameral antibiotics. Challenges remain, however, including increased multidrug-resistant bacterial endophthalmitis, increased fungal endophthalmitis, and the low but nonzero endophthalmitis rate attributable to the typical bacteria that colonize the ocular surface. Recent findings Povidone-iodine has a wide spectrum of activity, including activity against novel pathogens, such as SARS-CoV-2. Povidone-iodine alternatives, such as hypochlorous acid can have significantly less efficacy in vitro against endophthalmitis isolates. Repetitive application of dilute povidone-iodine has an excellent safety profile and strong evidence base for efficacy. Povidone-iodine is widely available, inexpensive, and commonly used by ophthalmologists. The repetitive application of dilute povidone-iodine is a well studied, well tolerated, and efficacious way to transiently sterilize the ocular surface during intraocular surgery. Additional benefits include activity against multidrug-resistant bacteria, fungi, and lack of inducible resistance.

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