povidone-iodine and Eye-Infections

To summarize current understanding of antibiotic prophylaxis in cataract surgery, with particular emphasis on available evidence and change in practice patterns over the past decade.. Povidone-iodine application prior to cataract surgery remains a universal practice, and is backed by good quality evidence. Subsequent to the results of the European multicenter trial documenting decreased risk of endophthalmitis with intracameral cefuroxime injection at the end of surgery, similar benefit with intracameral antibiotic use has been reported in studies with large sample sizes from multiple centers around the world. There has been a distinct change in practice patterns in many countries, with intracameral antibiotic use becoming part of routine protocol. In the USA, topical fluoroquinolone application remains the most popular mode of antibiotic prophylaxis. A promising approach is the development of novel drug delivery methods like polymeric devices designed for sustained antibiotic release.. Based on current evidence, the recommended measures for endophthalmitis prophylaxis are preoperative topical instillation of povidone-iodine and intracameral antibiotic injection at the end of cataract surgery.

Topics: Administration, Topical; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cataract Extraction; Cefuroxime; Endophthalmitis; Eye Infections; Humans; Injections, Intraocular; Postoperative Complications; Povidone-Iodine; Therapeutic Irrigation

To review techniques that are important in preventing endophthalmitis following intravitreous injections based on the available evidence.. A review of the literature regarding existing evidence that is relevant to post-injection endophthalmitis prophylaxis.. The available evidence regarding endophthalmitis prophylaxis is largely based on intraocular surgery, particularly cataract surgery. Despite the controversy and the paucity of evidence regarding endophthalmitis prophylaxis for intravitreous injections, it is recommended that povidone-iodine should be used prior to intravitreous injections to minimize or eliminate the presence of ocular surface bacteria. Administration of topical antibiotics may also be considered before and after the intravitreous injections. Strict adherence to aseptic techniques, including the use of an eyelide speculum is also important.. Endophthalmitic can occur following intravitreous injections. Prophylaxis with topical povidone-iodine, and possibly antibiotics, as well as adherence to aseptic technique may minimize the risk of post-injection endophthalmitis.

Topics: Anti-Bacterial Agents; Endophthalmitis; Eye Infections; Humans; Injections; Povidone-Iodine; Risk Factors; Vitreous Body

To evaluate the effects of current hygiene standards for the enucleation of postmortem eyes by investigating the number of microorganisms during subsequent steps of decontamination and tissue processing.. This prospective, non-randomized cohort study includes 184 postmortem eyes of 92 human donors. Enucleation was performed, according to an ophthalmic surgical procedure. Two groups were generated as follows: right eyes were allocated to group A, left eyes were allocated to group B. In group A, a mucosal disinfectant was used accessorily. Conjunctival smears were taken to examine germ load in both groups before any intervention, in group A after mucosal disinfection, in both groups after transportation of the whole globes in transport fluid, and in both groups after a bath in 0.75% povidone iodine solution for at least 3 minutes just before preparation of the corneoscleral disc. Smears were sent to the local microbiologic laboratory in an aseptic package for testing.. All smears showed multiple contaminations (n = 184/184 eyes) before treatment with povidone iodine solution. Contamination was in both groups significantly prevented using the treatment strategy of an at least 3-minute bath in 0.75% povidone iodine solution (n = 1/184 eyes; p < 0.01) As a side effect, almost every eye of group A and none of group B showed brown iodine staining corresponding to corneal epithelial erosion.. An aseptic setting for donor enucleation similar to a surgical procedure seems not to influence the outcome of germ colonization. The most effective step to decontaminate donor eyes is to use 0.75% povidone iodine solution for at least 3 minutes.

Topics: Anti-Infective Agents, Local; Cornea; Corneal Transplantation; Decontamination; Eye Banks; Eye Infections; Follow-Up Studies; Humans; Povidone-Iodine; Prospective Studies; Tissue and Organ Harvesting; Tissue Donors

To compare the effect of 1% versus 5% polyvinylpyrrolidone-iodine (PVP-I) chemical preparation (prep) of the eye on the recovery of organisms from donor globes before in situ recovery of donor corneal tissue.. One hundred consecutive pairs of donor corneas (200 eyes) were randomized to receive either 1% or 5% PVP-I drops applied to the conjunctival cul-de-sac, which was left in place for 2 minutes. Limbal cultures were obtained before and after prepping of the eye.. Twenty-five different species of organisms were recovered. Native flora of the eye included coagulase-negative staphylococci (62%), Corynebacterium species (27%), streptococcal species (9.5%), gram-negative bacilli (14.5%), Staphylococcus aureus (5%), anaerobes (10%), and yeast (2%). After PVP-I instillation of the donor eye, 74 isolates were recovered from the 1% P-I group and 76 isolates from the 5% PVP-I group. Cultures were sterile after PVP-I prep in 49 eyes and 47 eyes in the 1% PVP-I group and 5% PVP-I group, respectively. Microorganism colony forming units were similar among post-prep cultures from both PVP-I groups. The effect of the PVP-I prep on the number of negative cultures and on the reduction in the number of isolates was highly significant for both the 1% PVP-I group and the 5% PVP-I group when compared with the limbal cultures taken before PVP-I instillation.. This study found that 1% and 5% PVP-I solutions are equally effective for chemical prep of the donor eye. Because PVP-I is known to be toxic to the corneal endothelium and corneal fibroblasts, this study suggests that 1% PVP-I should be the preferred disinfectant for the recovery of corneal donors.

Topics: Anti-Infective Agents, Local; Bacteria; Colony Count, Microbial; Cornea; Disinfection; Eye Infections; Fungi; Humans; Microbiological Techniques; Povidone-Iodine; Prospective Studies; Specimen Handling; Tissue Donors

To correlate the incidence of postoperative endophthalmitis with changes in the preoperative prophylaxis over a 20-year period.. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.. Retrospective chart review.. Patients diagnosed with postoperative endophthalmitis from 1990 to 2009 after intraocular surgery performed at the same institution were included. Because of changes in the preoperative prophylaxis during the study period, 3 groups were formed for data analysis: Period 1 (1990 to 1992), no standardized prophylaxis regimen; period 2 (1993 to 1998), preoperative topical medication, povidone-iodine 10.0% periorbitally, and 1 drop of povidone-iodine 1.0% in the conjunctiva sac; and period 3 (1999 to 2009), similar to period 2 except with irrigation of the conjunctival sac with 10 mL of povidone-iodine 1.0%.. The overall rate of postoperative endophthalmitis was 0.113% (77/68,323) for all intraocular surgeries. It decreased significantly from 0.291% (16/5505) in period 1 to 0.170% (33/19,413) in period 2 to 0.065% (28/43,405) in period 3 (P < .001). In cataract surgery, the overall rate of postoperative endophthalmitis was 0.125% (30/24,034). It decreased in each subsequent period, from 0.338% (9/2662) in period 1 to 0.224% (15/6696) in period 2 to 0.041% (6/14,676) in period 3 (P < .001). Coagulase-negative Staphylococcus was the most commonly isolated organism (47.4%).. The rate of postoperative endophthalmitis decreased over a 20-year period at a single academic institution. Although multiple factors might have contributed to this decline, implementation of a preoperative prophylaxis protocol using copious povidone-iodine might have been the most important contributor.. No author has a financial or proprietary interest in any material or method mentioned.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anterior Chamber; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacteria; Cataract Extraction; Child; Child, Preschool; Endophthalmitis; Eye Infections; Female; Fungi; Humans; Incidence; Infant; Male; Middle Aged; Postoperative Complications; Povidone-Iodine; Pre-Exposure Prophylaxis; Retrospective Studies

Topics: Anti-Infective Agents, Local; Cataract Extraction; Endophthalmitis; Eye Infections; Female; Humans; Male; Postoperative Complications; Povidone-Iodine; Pre-Exposure Prophylaxis

Topics: Anti-Infective Agents, Local; Cataract Extraction; Endophthalmitis; Eye Infections; Female; Humans; Male; Postoperative Complications; Povidone-Iodine; Pre-Exposure Prophylaxis

Topics: Anti-Infective Agents, Local; Cataract Extraction; Endophthalmitis; Eye Infections; Female; Humans; Male; Postoperative Complications; Povidone-Iodine; Pre-Exposure Prophylaxis

Topics: Anti-Infective Agents, Local; Cataract Extraction; Endophthalmitis; Eye Infections; Female; Humans; Male; Postoperative Complications; Povidone-Iodine; Pre-Exposure Prophylaxis

This study assessed the effectiveness of one vs two applications of povidone-iodine in decontaminating the eye before cataract surgery.. This was a prospective, interventional study of 52 patients having elective unilateral phacoemulsification cataract surgery in a tertiary care centre. Each patient had two applications of povidone-iodine before phacoemulsification cataract surgery, separated by 10 min. Conjunctival swabs were taken before and after each application and cultured in 5% CO(2) and anaerobically. Statistical analysis was performed using McNemar's test for correlated proportions.. In all, 15 of 52 (29%) patients had positive cultures before the first application and 21 of 52 (40%) patients had positive cultures after it. This was not statistically significant (P=0.239). A total of 25 of 52 (48%) patients were culture positive before the second application. This was not statistically significantly different from 10 min earlier (P=0.423). Six of 52 (12%) patients were positive after the second application (P<0.001).. We conclude that the initial application of povidone-iodine was not effective in decontaminating the eye. Recontamination did not take place between applications. The difference in the proportion of patients with positive results before and after the second application of povidone-iodine was statistically significant. We infer from this that double application of povidone-iodine before cataract surgery is advisable.

Topics: Anti-Infective Agents, Local; Antibiotic Prophylaxis; Bacteria; Conjunctiva; Eye Infections; Humans; Phacoemulsification; Povidone-Iodine; Preoperative Care; Prospective Studies

The recommendations for the 2010 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines in regard to diagnosis and treatment of gonococcal and Chlamydia trachomatis infections in infants and children are essentially the same as the 2006 guidelines. There are no new data on the diagnosis or treatment of neonatal chlamydial or gonococcal infections. New data on the efficacy of neonatal ocular prophylaxis are limited. Two recent studies from Iran and Brazil suggest that povidone-iodine may not be effective for prevention of chlamydial or gonococcal ophthalmia. Prenatal screening and treatment of pregnant women, which has been demonstrated to be very effective for the prevention of neonatal gonococcal ophthalmia, is the most effective strategy for preventing neonatal chlamydial infection.

Topics: Anti-Infective Agents; Chemoprevention; Child; Child, Preschool; Chlamydia Infections; Chlamydia trachomatis; Eye Infections; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Neisseria gonorrhoeae; Povidone-Iodine; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications, Infectious

The aim of this study was to assess the risk of postoperative endophthalmitis associated with different prophylactic protocols, using povidone-iodine disinfection of the skin and conjunctiva in patients undergoing cataract surgery over an 8-year period at Chang Gung Memorial Hospital (Kaohsiung, Taiwan).. This was a retrospective, comparative, case-controlled study. Data were collected on patients who received different prophylactic disinfection protocols prior to extracapsular cataract extraction with intraocular lens implantation between January 1992 and January 2000. Possible risk factors for the occurrence of postoperative endophthalmitis were analyzed.. Medical charts for a total of 10,614 extracapsular cataract extraction surgeries performed during the 8-year period were reviewed, and 12 eyes that developed postoperative endophthalmitis were identified and analyzed. Another 120 eyes matched for age and gender of the patient were randomly selected as controls. Skin preparation with 5% povidone-iodine was associated with an increased risk of postoperative infection, compared to that of 10% povidoneiodine. On the conjunctiva, a lack of 5% povidone-iodine disinfection was associated with an increased risk of postoperative infection, compared to 5% povidone-iodine disinfection.. Preoperative skin disinfection with 10% povidone-iodine and conjunctival disinfection with 5% povidone-iodine significantly reduced the relative risk of postoperative endophthalmitis.

Topics: Aged; Anti-Infective Agents, Local; Case-Control Studies; Cataract Extraction; Disinfection; Endophthalmitis; Eye Infections; Female; Humans; Male; Middle Aged; Postoperative Complications; Povidone-Iodine; Preoperative Care; Retrospective Studies; Risk Factors; Skin