["Iodine allergy" : A medical myth with risks for the ophthalmological patient].
BACKGROUND
Preoperative disinfection with povidone-iodine results in a significant reduction of the risk for postoperative endophthalmitis and secondary irreversible vision loss in intraocular surgeries and intravitreal injections. Nevertheless, this important measure is often omitted if so-called "iodine allergy" is suspected. We analyze the physiological and allergological basis for the construct of "iodine allergy".


METHODS
This article is based on a selective literature review using the search term "allergy" in combination with "iodine", "povidone", "indocyanine green", or "seafood".


RESULTS
Iodine is a chemical element and an essential component of the human body. Scientific proof for the existence of an antibody-mediated allergic reaction (type I reaction) and in particular an immunoglobulin (Ig) E‑mediated anaphylaxis against iodine is lacking. Chemical irritations and contact allergies (type IV reaction) induced by iodine-containing disinfectants are not antibody-mediated and do not cause anaphylaxis (type I reaction). The uncommon antibody-mediated allergies against iodine-containing disinfectants, fluorescent dyes, radiocontrast media, or seafood are not directed against the contained iodine itself but against other components of the respective formulation. Thus, allergic cross-reactivities between these different substance groups are not to be expected.


CONCLUSIONS
So-called "iodine allergy" is a medical myth lacking a scientific basis and should not result in increased patient risks due to omitted preoperative disinfection.
Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland. krohne@uni-bonn.de.
T U
TU
Krohne
Klinik und Poliklinik für Dermatologie und Allergologie, Universität Bonn, Bonn, Deutschland.
J-P
JP
Allam
Klinik und Poliklinik für Dermatologie und Allergologie, Universität Bonn, Bonn, Deutschland.
N
N
Novak
Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
F G
FG
Holz
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000009:adverse effects; D019072:Antibiotic Prophylaxis / Q000009:adverse effects / Q000379:methods*; D003877:Dermatitis, Contact / Q000209:etiology / Q000517:prevention & control*; D004202:Disinfectants / Q000008:administration & dosage / Q000009:adverse effects; D009877:Endophthalmitis / Q000209:etiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D004202:Disinfectants; D007455:Iodine
Anaphylaxis; Disinfection; Indocyanine green; Povidone-iodine; Radiocontrast media