Postoperative povidone-iodine prophylaxis in strabismus surgery.
OBJECTIVE
While antibiotic/steroid combinations are routinely administered during the first week after strabismus surgery, they can be costly and inconvenient and may be unnecessary. This study compares the use of single-dose 5% povidone-iodine drops versus a week-long course of antibiotic/steroid as a prophylaxis against postoperative infection in extraocular muscle surgery.


METHODS
Retrospective chart review was performed of 1871 patients undergoing routine strabismus surgery. Patients received either a single application of 5% povidone-iodine solution to the operative eye(s) at the conclusion of the surgical procedure or a week-long course of topical antibiotic/steroid. Postoperative records were then reviewed to identify abnormalities or complications occurring during the first 2 months after surgery.


RESULTS
Complete documentation was found for 1603 patients. Single-dose povidone-iodine prophylaxis was used in 953 cases (59.5%), and a postoperative course of topical antibiotic/steroid combination was used in 650 cases (40.5%). Of the 1603 cases, possible infection occurred in 46 patients (2.87%). Of the 46 possible infections, 20 (3.08%) occurred in 650 patients on an antibiotic/steroid combination and 26 (2.83%) occurred in the 953 patients treated with single-dose povidone-iodine prophylaxis. This difference was not statistically significant (p = 0.6815). No cases of orbital cellulitis or endophthalmitis occurred in either group.


CONCLUSIONS
Single-dose povidone-iodine is an inexpensive alternative to postoperative antibiotic/steroid prophylaxis following routine strabismus surgery performed through a fornix incision. Patients who had reoperations and limbal incisions were more likely to have complicated postoperative courses: antibiotic/steroid use in these groups may be beneficial.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011206:Povidone-Iodine / Q000008:administration & dosage*; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D014031:Tobramycin / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone; D011206:Povidone-Iodine; D014031:Tobramycin