Prophylaxis of endophthalmitis with topical povidone-iodine.
The authors conducted an open-label nonrandomized parallel trial to examine whether the preoperative application of povidone-iodine to the ocular surface reduces the incidence of endophthalmitis after intraocular surgery. During an 11-month period, topical 5% povidone-iodine was used to prepare the conjunctiva in 1 set of 5 operating rooms, while silver protein solution was used in another set of 5 rooms. In all cases, surgeons continued to use their customary prophylactic antibiotics. A significantly lower incidence of culture-positive endophthalmitis (P less than 0.03) was observed in the operating rooms using povidone-iodine (2 of 3489 or 0.06%) compared with those using silver protein solution (11 of 4594 or 0.24%). Use of topical povidone-iodine in over 3000 cases was not associated with any adverse reactions. In a majority of the observed cases of endophthalmitis, some form of intraoperative communication with the vitreous cavity existed.
Speaker
M G
MG
Department of Ophthalmology, New York Eye and Ear Infirmary, New York 10003.
Menikoff
J A
JA
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D003228:Conjunctiva / Q000187:drug effects; D009877:Endophthalmitis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009873:Operating Rooms; D011183:Postoperative Complications / Q000517:prevention & control; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D012836:Silver Proteins / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D012836:Silver Proteins; D011206:Povidone-Iodine