povidone-iodine and Cataract

This study was conducted to ensure the integrity of surgery wounds.. This was a randomized prospective trial of 300 patients who underwent small-incision cataract surgery (SICS) at our hospital over a one-year period. We used 2-3 drops of 5% povidone-iodine at the end of each case, not only to disclose any wound leaks but also to sterilize the surface of the eye.. Three hundred patients underwent SICS. One hundred ten patients had postoperative wound leak in SICS due to surgical complications. Premature entry comprising 75% (83 cases), followed by floppy iris syndrome comprising 20% (22 cases) and 5% (6 cases) comprising pseudoexfoliation (PXF) syndrome. There was a drop in the number of re-surgeries from 12 to 3 cases since we started implementing this technique.. The simple procedure is very handy and economical in identifying the leak and can reduce further complications such as endophthalmitis and re-surgeries. Among residents, this can be a boon where povidone-iodine acts as a riverbank for the outflow of aqueous, outlining the speed, location, and quantity of the leak. Siep's test plays an important role in identifying any postoperative wound leaks and also sterilizing the eye surface post surgery.

Topics: Cataract; Cataract Extraction; Humans; Postoperative Complications; Povidone-Iodine; Prospective Studies; Retrospective Studies; Surgical Wound

To evaluate the effect of a single administration of topical povidone-iodine (PVI) 10% plus levofloxacin 0.5% at 1 hour before cataract surgery on perioperative elimination rate of conjunctival flora.. Poostchi Ophthalmology Research Center, Shiraz, Iran.. Randomized controlled trial.. Patients who required cataract surgery were randomly assigned to 1 of 2 groups: intervention (administration of PVI 10% plus levofloxacin 0.5% at 1 hour preoperatively) or control. The patients in both groups received PVI just before the operation. Conjunctival cultures were obtained using thioglycollate broth at 4 timepoints: T1, before intervention; T2, before the second application of PVI; T3, 3 minutes after the second administration of PVI; and T4, just postoperatively.. The study comprised 142 patients. The comparative rates of positive cultures in the intervention vs control groups were as follows: T1 (70.4% vs 73.2%, P = .709); T2 (15.5% vs 71.8%, P < .001); T3 (7.0% vs 19.7%, P = .027); and T4 (5.6% vs 4.2%, P = .698). Coagulase-negative Staphylococci was the most common isolated microorganism.. Results showed that a single adjuvant application of PVI 10% plus levofloxacin 0.5% eyedrops at 1 hour before operation leads to a further increase in the rate of sterile conjunctiva just preoperatively.

Topics: Administration, Topical; Anti-Bacterial Agents; Cataract; Cataract Extraction; Conjunctiva; Humans; Iran; Levofloxacin; Ophthalmology; Povidone; Povidone-Iodine

Povidone-iodine (PI, Betadine) is routinely used as a preoperative topical antiseptic in cataract surgery as it has been shown to reduce the incidence of postoperative endophthalmitis. However, the concentration used clinically is variable. In vitro studies have shown that PI is paradoxically more effective at lower concentration. This study was undertaken to determine if this effect was reproducible in vivo.. A prospective randomised double blind study was carried out in the ophthalmic theatre in a district general hospital. 105 patients attending for routine cataract surgery were randomly allocated to have their conjunctival fornices irrigated preoperatively with either PI 1% (group A) or PI 5% (group B). Conjunctival swabs were taken, in identical fashion, both before and 1 minute after irrigation. The number and species of bacterial colonies cultured from each swab was counted. The difference in the median number of bacterial colonies from pre-irrigation to post-irrigation cultures was then compared between the groups.. Bacterial cultures were gained from 100 patients (33 male, 67 female, mean age 74 years, range 30-95 years). Group B (5% PI) showed a decrease in median colony forming units (CFU) pre-irrigation from 100 to 40 CFU post-irrigation (a drop of 60%). This was greater than in group A (1% PI) where the reduction was 120 CFU pre-irrigation to 100 CFU post-irrigation (a drop of 16.7%) (Mann-Whitney test, p<0.05). At higher initial bacterial loads (CFU pre-irrigation >1000), the difference in median between the two groups became larger as the number of pre-irrigation bacteria increased. In group B pre-irrigation CFU reduced from 3340 to 110 post-irrigation (a drop of 96.7%) compared with group A: 5000 CFU pre-irrigation to 3000 post-irrigation (a drop of 40%) (Mann-Whitney test, p=0.0014).. Despite in vitro evidence of higher bactericidal efficacy of PI at more dilute concentrations, 5% PI is more effective than 1% PI in decreasing the human conjunctival bacterial flora in vivo, particularly in the presence of heavier initial bacterial load.

Topics: Adult; Aged; Aged, 80 and over; Anti-Infective Agents, Local; Cataract; Cataract Extraction; Colony Count, Microbial; Double-Blind Method; Female; Humans; Iodophors; Male; Middle Aged; Povidone-Iodine; Preoperative Care; Prospective Studies; Solutions

The study analyzes the frequency of acute endophthalmitis occurrence after cataract surgery, the risk factors, characteristic symptoms, and the effectiveness of peri-operative prevention measures.. The study retrospectively analyzed 59 670 cases of patients operated for cataract in 2017-2021. To prevent infections, patients received four instillations of third generation fluoroquinolone (quinolone antibiotic) in the course of two days prior to cataract phacoemulsification (PE), and two instillations immediately (1 hour and 30 minutes) before the surgery; three-minutes treatment of the cornea, conjunctival sac and periocular skin with 5% povidone iodine before the surgery; and as the last step of surgery, patients received subconjunctival injection of 0.05 g cefazolin with 2 mg dexamethasone. Follow-up after surgery included four injections of 0.5% levofloxacin in the course of 7-10 days, and 0.1% dexamethasone for two weeks, or fixed combination of tobramycin and dexamethasone four times per day for two weeks. The criteria for acute endophthalmitis are: loss of spatial vision, absence of red reflex, pronounced thickening of the choroid, suspended particulates in the retrovitreal space and the vitreous observed with ultrasonography in the early postoperative period (day 4-7 after surgery).. Povidone iodine and third generation fluoroquinolone as a method of acute endophthalmitis prevention after cataract surgery demonstrate comparable efficacy to intracameral antibiotic injections.. Анализ частоты возникновения острого эндофтальмита (ОЭ) после хирургии катаракты, факторов риска его развития, наиболее характерных симптомов, а также эффективности применявшихся схем периоперационной профилактики.. Проведен ретроспективный анализ историй болезни 59 670 пациентов, оперированных по поводу катаракты в 2017—2021 гг. Профилактика инфекции включала в себя четырехкратную на протяжении двух предшествующих госпитализации суток, затем двукратную (за 60 и 30 мин до начала вмешательства) инстилляцию фторхинолона третьего поколения, трехминутную обработку периокулярной области и глазной поверхности 5% раствором повидон-йода, завершение факоэмульсификации субконъюнктивальной инъекцией 0,05 г цефазолина и 2 мг дексаметазона с последующими четырехкратными инстилляциями 0,5% раствора левофлоксацина на протяжении 7—10 сут и 0,1% раствора дексаметазона в течение 2 нед либо 14-дневным использованием фиксированной комбинации (ФК) тобрамицина и дексаметазона с частотой инстилляций 4 раза в сутки. Критерии ОЭ — утрата предметного зрения, исчезновение розового рефлекса, выраженное утолщение сосудистой оболочки, мелкоточечная взвесь в ретровитреальном пространстве и стекловидном теле, по данным УЗИ, в раннем (4—7-е сутки) послеоперационном периоде.. Интраоперационное применение повидон-йода и периоперационная терапия фторхинолоном третьего поколения демонстрируют сопоставимую с внутрикамерным введением антибиотика эффективность профилактики ОЭ после хирургии катаракты.

Topics: Anti-Bacterial Agents; Bacillaceae; Cataract; Cataract Extraction; China; Dexamethasone; Endophthalmitis; Estuaries; Eye Infections, Bacterial; Genome, Bacterial; Geologic Sediments; Humans; Levofloxacin; Phylogeny; Postoperative Complications; Povidone-Iodine; Retrospective Studies; Tobramycin

To determine current institutional practice patterns for the use of perioperative antibiotics and other measures to prevent infection after cataract surgery in Asia.. An online survey-based study of leading eye institutions in China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, South Korea, Taiwan, Thailand and Vietnam was conducted. The survey was administered to 26 representative key opinion leaders from prominent tertiary eye institutions that are also national academic teaching institutions in Asia. Survey responses were collated and anonymized during analysis.. All surveyed institutions used povidone iodine for the preoperative antiseptic preparation of the eye, with notable variations in the concentration of povidone iodine used for conjunctival sac instillation. Preoperative topical antibiotics were prescribed by 61.5% and 69.2% of institutions in low-risk and high-risk cases, respectively. Regarding the use of intra-operative antibiotics, 60.0% and 66.7% of institutions administered intracameral antibiotics in low-risk and high-risk patients, respectively. Postoperative topical antibiotics use patterns were generally very similar in low-risk and high-risk patients. Over half of the institutions (52.2% and 68.0% in low-risk and high-risk patients, respectively) also indicated prolonged postoperative use of topical antibiotics (> 2 weeks). Not all surveyed institutions had established policies/protocols for perioperative antibiotic use in cataract surgery, endophthalmitis surveillance, and/or a monitoring program for emerging antimicrobial resistance.. There are variations in antimicrobial prophylaxis approaches to preoperative, intra-operative and postoperative regimens in cataract surgery in Asia. More evidence-based research is needed to support the development of detailed guidelines for perioperative antibiotic prophylaxis to reduce postoperative infections.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Cataract; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Postoperative Complications; Povidone-Iodine

Topics: Cataract; Cataract Extraction; Conjunctiva; Humans; Levofloxacin; Povidone; Povidone-Iodine

Topics: Cataract; Cataract Extraction; Conjunctiva; Humans; Levofloxacin; Povidone; Povidone-Iodine

Topics: Anti-Infective Agents, Local; Cataract; Cataract Extraction; Humans; Povidone-Iodine; Preoperative Care

Topics: Anti-Infective Agents, Local; Cataract; Cataract Extraction; Humans; Povidone-Iodine; Preoperative Care

Endophthalmitis is one of the most serious complications of cataract surgery. The surgeons try to reduce the incidence of endophthalmitis. In order to prevent postoperative infection, irrigation of the conjunctival sac with povidone iodine and injection of antibiotics into the anterior chamber before the end of the surgery are used. Although there are a lot of reports about the concentration, mode and duration of povidone iodine application, there is no consensus. There are many options for antibiotics, including cefuroxime, vancomycin and moxifloxacin. Side effects of using povidone iodine and antibiotics have also been reported. An aseptic surgical mask plays an important role in isolating bacteria for prevention of infection. However, whether it could completely isolate bacteria can not be determined. In this article, several issues concerning the prevention of infection after cataract surgery are discussed. We hope that there will be a multi-center and large-sample research to assist in drawing up operating specifications.. 感染性眼内炎是白内障摘除手术最严重的并发症之一，如何减少白内障摘除术后感染性眼内炎的发生备受关注。目前临床常采用聚维酮碘结膜囊灌洗、手术末前房注射抗生素等方法预防术后感染。聚维酮碘的应用浓度、方式以及作用时间国内外尚无统一意见，用于前房注射的抗生素也有很多选择，各种方法均存在不良反应。无菌手术贴膜在术中隔离菌群、预防感染方面发挥了重要的作用，但效果尚无法确定。本文就白内障摘除术后预防感染中值得关注的问题进行分析讨论，以期为开展多中心、大样本研究提供参考，制定相应的操作规范。

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Cataract; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Postoperative Complications; Povidone-Iodine

Aim of the study was to determine the role of surgery in the management of congenital chylothorax (CC).. We retrospectively reviewed the data of patients with CC requiring medical or surgical treatment postnatally in our institution between January 2001 and March 2009.. Ten patients were treated for CC. We divided our population into 2 groups: group A consisted of patients in whom CC healed after conservative medical treatment (thoracocentesis, pleural drainage, total parental nutrition, somatostatin, intrapleural injections of povidone-iodine), and group B of patients who needed both medical and surgical treatment (pleural abrasion and/or pleurectomy). Conservative postnatal therapy was successful in 50% of cases. Of the 3 patients treated preoperatively with intrapleural injections of povidone-iodine, 2 presented with severe complications. Surgical treatment was successful in all cases, with no surgical complications. Patients in group B had a significantly lower birth term (p=0.0254) and birth weight (p=0.0021) compared to patients in group A. Patients with a massive chylothorax (≥50 mL/kg/day) needed surgery significantly more often than those with chylothorax <50 mL/kg/day (p=0.0119).. The initial postnatal medical management of CC should consist of thoracocentesis, drainage by tube thoracostomy, and total parenteral nutrition. If this treatment fails after 10 days, we propose using alternative therapies such as somatostatin (although its efficacy is not clear) and surgery. Chemical pleurodesis by intrapleural injection of povidone-iodine must be avoided in infants and small babies. Surgical management by pleural abrasion and/or pleurectomy appears to be safe and effective. Early surgical management is proposed for babies with low birth term, birth weight and massive chylothorax >50 mL/kg/day. Long-term follow-up is needed to evaluate the potential consequences of this therapy.

Topics: Birth Weight; Cataract; Chylothorax; Humans; Length of Stay; Pleurodesis; Povidone-Iodine; Retrospective Studies; Thoracic Surgery, Video-Assisted; Thoracoscopy