title: Systemic iodine absorption associated with the use of preoperative ophthalmic antiseptics containing iodine.
abstract: BACKGROUND
  Polyvinylpyrrolidone-Iodine (PVP-I) is routinely used as preoperative antiseptic during ophthalmic surgery. Iodine absorption from iodine-containing antiseptics can lead to the development of thyroid disorders. Therefore, a quantitative measurement of iodine absorption from these antiseptics was performed in patients undergoing elective cataract surgery.
  
  
  METHODS
  This study enrolled 241 patients to evaluate systemic iodine absorption after exposure to conjunctival and/or periorbital 1.25% and 10% PVP-I compared to an iodine-free antiseptic.
  
  
  RESULTS
  All patients who received the 10% PVP-I regardless of the application site showed a 1.2-1.5-fold increase in urinary iodine excretion after 24 h (p = 0.01). In 17 out of 110 (15.5%) patients in whom 10% PVP-I was used, the critical threshold of urinary iodine excretion as defined by WHO (>300 µg/L) was exceeded. In contrast, no significant ioduria was observed with the use of 1.25% PVP-I except in patients after 48 h (p = 0.01) and with a concurrent conjunctival and periorbital application. The proportion of the excreted iodine in urine ranged from 0.24% to 1.77%. No correlation was found between the total applied concentration of iodine and the amount excreted in urine.
  
  
  CONCLUSIONS
  Based on our findings, we believe that the use of 10% PVP-I as preoperative ophthalmic antiseptic should undergo further clinical evaluation in regard to its impact on thyroid function. Conjunctival or periorbital application of 1.25% PVP-I does not result in significant ioduria.
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ernst-Moritz-Arndt University, Germany. behzadr@hotmail.com
authors.forename: Behzad
authors.initials: B
authors.lastname: Razavi
authors.forename: Richard
authors.initials: R
authors.lastname: Zollinger
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
authors.forename: Cordula
authors.initials: C
authors.lastname: Fricke
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Bernd
authors.initials: B
authors.lastname: Jäger
authors.forename: Christin
authors.initials: C
authors.lastname: Spielhagen
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Behrens-Baumann
authors.forename: Harald
authors.initials: H
authors.lastname: Below
mesh_terms: D000042:Absorption; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000493:pharmacokinetics* / Q000652:urine; D019072:Antibiotic Prophylaxis; D005260:Female; D006801:Humans; D007455:Iodine / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000493:pharmacokinetics* / Q000652:urine; D057234:Preoperative Period; D012996:Solutions
chemical_list: D000891:Anti-Infective Agents, Local; D012996:Solutions; D011206:Povidone-Iodine; D007455:Iodine