title: Vitrectomy using 0.025% povidone-iodine in balanced salt solution plus for the treatment of postoperative endophthalmitis.
abstract: OBJECTIVE
  To investigate the bactericidal effect of 0.025% povidone-iodine in Balanced Salt Solution PLUS (0.025% PI-BSS PLUS) and its use in vitrectomy for postoperative endophthalmitis.
  
  
  METHODS
  First, an experimental laboratory model using Staphylococcus aureus was used to evaluate the bactericidal effect of PI-BSS PLUS. Next, in a case series of 4 eyes with postoperative endophthalmitis, vitrectomy using 0.025% PI-BSS PLUS as irrigation solution was conducted, followed by postoperative intravitreal and intravenous antibiotics.
  
  
  RESULTS
  In in vitro study, PI at concentrations of 0.01% and above in BSS PLUS exhibited marked bactericidal effect after 15 seconds of exposure. Bactericidal effect of 0.025% PI-BSS PLUS was maintained at room temperature storage for 15 minutes but was attenuated after 30 minutes. Among 4 eyes that underwent vitrectomy using 0.025% PI-BSS PLUS, coagulase-negative Staphylococcus sp. was isolated in 1 eye at the beginning but not at completion of surgery. In all four eyes, endophthalmitis was resolved with no adverse events. Ocular toxicity was not observed.
  
  
  CONCLUSIONS
  The 0.025% PI-BSS PLUS is bactericidal and nontoxic when used as irrigation solution in vitrectomy. In 4 cases of postoperative endophthalmitis, vitrectomy using 0.025% PI-BSS PLUS followed by postoperative antibiotics resolved endophthalmitis.
authors.affiliation: *Department of Ophthalmology, School of Medicine, Nihon University, Tokyo, Japan; and †Sagami Research Laboratories, Kanagawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakashizuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hattori
authors.forename: Takayasu
authors.initials: T
authors.lastname: Noguchi
authors.forename: Naomi
authors.initials: N
authors.lastname: Kokubo
authors.forename: Mitsuko
authors.initials: M
authors.lastname: Yuzawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001639:Bicarbonates / Q000008:administration & dosage*; D015169:Colony Count, Microbial; D003131:Combined Modality Therapy; D004338:Drug Combinations; D009877:Endophthalmitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005978:Glutathione / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011183:Postoperative Complications; D011206:Povidone-Iodine / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D013211:Staphylococcus aureus / Q000187:drug effects; D007507:Therapeutic Irrigation; D014821:Vitrectomy
chemical_list: D000891:Anti-Infective Agents, Local; D001639:Bicarbonates; D004338:Drug Combinations; C013003:glutathione-bicarbonate-Ringer solution; D011206:Povidone-Iodine; D005978:Glutathione