Outpatient Topical Use of Povidone-iodine in Preparing the Eye for Surgery

Apt, Leonard; Isenberg, Sherwin J.; Yoshimori, Robert; Spierer, Abraham

doi:10.1016/s0161-6420(89)32897-1

Cited by 105 publications

(37 citation statements)

References 17 publications

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“…Recently recommended preparations to reduce the risk of postoperative endophthalmitis in cataract surgery in clude antibiotics in the intraocular irrigating solution [ 13,14] and the routine use of povidone-iodine as a preopera- five disinfectant [15][16][17], Controversy remains over the use of antibiotics especially vancomycin, because of prob able adverse effects, the induction of vancomycin-resis tant bacteria, and financial limitations [18,19], To define the most appropriate preoperative preparation of the external eye against endophthalmitis, we evaluated the species and incidence of bacteria in the conjunctiva and lids which may gain access into the eye during cataract surgery [2][3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…Bacteriological studies on the external eye have usually failed to record the presence of anaerobic bacteria [2,[5][6][7]20], However, using appropriate culture media and prop er anaerobic techniques, some reports have recently docu mented anaerobic bacteria as part of the normal conjunc tival flora [3,4,[14][15][16]21,22], and a cause of endophthal mitis [23][24][25][26], P. acnes is the most commonly isolated anaerobic bacterium, being found in 10-50% of conjunc tiva [21,22], In our study, P. acnes was obtained from the conjunctiva of 63 (12.9%) of 488 eyes undergoing cataract surgery. The spectrum and frequency of microorganisms in this study correspond with previous reports [14,22], Doyle et al [14] documented that culture from the con junctival sac showed coagulase-negative Staphylococcus in 70%, P. acnes in 47%, Staphylococcus aureus in 6%, and Corynebacterium in 6% of 17 patients ready for cata ract surgery.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Disinfection of the Conjunctival Sac in Cataract Surgery

1997

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Conjunctival cultures were obtained from 488 patients undergoing cataract extraction. Bacterial isolation rates from the lids and conjunctiva were 84.6 and 36.7, respectively. Propionibacterium acnes was the only anaerobic organism identified. A significantly lower incidence of P. acnes was observed in the eyes after preoperative conjunctival irrigation using povidone-iodine solution (9%) compared with those using benzetonium chloride solution (30%). Topical use of ofloxacin and cefmenoxime for 1 or 2 days preoperatively, and irrigation of the conjunctival sac with a 16-fold-diluted povidone-iodine solution for at least 30 s immediately prior to cataract surgery are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative Disinfection of the Conjunctival Sac in Cataract Surgery

1997

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“…25 and Apt et al 26. 42 They have shown that irrigation of the conjunctiva with half-strength 5% povidone-iodine reduces the total conjunctival bacterial colony count by about 90% and the number of different bacterial species cultured from the conjunctiva by about 50%. Even more effective, however, is the combination of a three-day, three times a day preoperative course of topical broad-spectrum antibiotic (neomycin/gramicidine/polymyxin B) followed by topical irrigation of the conjunctival sac with povidone-iodine.…”

Section: Culture-negat Ive Endoph Tha Lrn It Ismentioning

confidence: 99%

Endophthalmitis in Auckland 1983–1991

Kent

1993

Australian and New Zealand Journal of Ophthalmology

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A review was made of 58 cases of suspected endophthalmitis presenting to Auckland Public Hospital between January 1983 and July 1991 (103 months). Thirty culture positive cases were found comprising 13 early onset postoperative, six delayed onset postoperative, five bleb-associated, four post-traumatic and two endogenous cases. The most frequent organism grown in postoperative en do p h t h al m i t is was Staphylococcus epidermidis. No conclusion could be reached as to the effectiveness of early versus delayed vitrectomy. Endophthalmitis due to S. epidermidis usually had a good prognosis while streptococcal endophthalmitis had a poor prognosis. Delayed-onset postoperative endophthalmitis most often had a good prognosis while bleb-associated endophthalmitis had a uniformly poor visual outcome. Two isolates responsible for cases of delayed-onset postoperative endop h t h al m it is, Propionibacterium acnes and Rhodococcus species, did not grow on agar plates until the seventh day of culture. Significant bacterial resistance to cephazolin was identified with 33% of Gram-positive and 75% of Gram-negative isolates resistant. Prevention of postoperative endophthalmitis is discussed.

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“…Apt et al [6]studied 40 patients and concluded that the best preoperative regimen was the combination of Neosporin on an outpatient basis for 3 days with PVP-I 5% solution applied to the eye at the beginning of the preoperative preparation.…”

Section: Preoperative Applicationmentioning

confidence: 99%

Ocular Applications of Povidone-Iodine

Isenberg¹,

Apt²,

Campeas³

2002

Dermatology

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Ocular infections can have devastating consequences and may lead to blindness. Povidone-iodine (PVP-I) has many potential advantages over the currently used drugs, including a broader antibacterial spectrum, it turns the surface of the eye brown for a few minutes, bacterial resistance has not been seen and it is cheaper than other agents. PVP-I has made a significant contribution to pre- and postoperative ocular surgical prophylaxis, ophthalmia neonatorum prophylaxis and treatment of bacterial conjunctivitis. Scientific support for these applications includes studies conducted over the past 17 years, which are reviewed.

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Outpatient Topical Use of Povidone-iodine in Preparing the Eye for Surgery

Cited by 105 publications

References 17 publications

Preoperative Disinfection of the Conjunctival Sac in Cataract Surgery

Preoperative Disinfection of the Conjunctival Sac in Cataract Surgery

Endophthalmitis in Auckland 1983–1991

Ocular Applications of Povidone-Iodine

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