povidone-iodine and Myopia

To determine the frequency and severity of ocular symptoms and signs in new orthokeratology (ortho-k) subjects using a povidone iodine (PI) disinfecting system compared to those present before lens wear, and whether these were associated with cleaning regimes.. This study recruited 80 subjects from two myopia control studies, who used a PI disinfecting solution for routine use. Ocular symptoms and signs at baseline, one- and six-month after lens wear were reported via questionnaires and ocular examination, respectively. To determine if rates of occurrence were attributable to differences in cleaning regime, subjects were randomly assigned into four groups with respect to routine care procedures, which involved various combinations of rubbing and use of a daily and/or enzymatic cleaner.. Sixty-eight subjects completed all aspects of the study. As there were no significant differences in incidence of signs and symptoms between the four groups before and after lens wear (Friedman tests, p > 0.07), data were combined for further analysis. Prior to lens wear, itchiness (69 %) and dryness (53 %) were the most commonly reported symptoms. The frequency and severity of all symptoms remained similar after lens wear (p > 0.10). Presence of follicles in the lower tarsal conjunctiva (22 %) and conjunctival injection (15 %) was frequently observed, but reduced significantly after lens wear (p < 0.01). Mild corneal staining, noted in 13 % of subjects at baseline, did not change significantly over time (p = 0.17). Ocular signs were not necessarily reflected in symptoms and vice versa.. Use of a PI-based solution did not increase the frequency or severity of ocular signs and symptoms observed before lens wear. Absence of a difference in occurrence of ocular discomfort with respect to cleaning regimes indicated that the use of the PI-based solution may adequately clean the lenses over a 6-month period.

Topics: Conjunctiva; Humans; Lens, Crystalline; Myopia; Povidone-Iodine; Vision, Ocular

We report the successful management of a rare case of bilateral post-laser in situ keratomileusis (LASIK) Fusarium oxysporum keratitis and propose a therapeutic strategy. A 19-year-old white man with no systemic diseases was referred to our emergency service 3 days after microkeratome-assisted myopic bilateral LASIK correction. He complained of blurred-vision, photophobia, and ocular pain. Clinical findings (satellite lesions, hypopyon) suggested fungal keratitis. Flaps were immediately lifted and rinsed with povidone-iodine 10%, and intensive topical and systemic and combined antifungal and antibacterial treatment was introduced. Topical cortisone drops were administered after 3 days. Despite initial deterioration of the clinical picture, all symptoms resolved quickly. Polymerase chain reaction indicated F oxysporum. Relapse occurred in the left eye, which was successfully managed. The final uncorrected distance visual acuity was 20/20 in both eyes. Fusarium oxysporum post-LASIK keratitis may occur in the early phase. Prompt diagnosis, interface irrigation with povidone-iodine solution, and intensive long-term treatment contribute to a favorable outcome.. No author has a financial or proprietary interest in any material or method mentioned.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Corneal Ulcer; DNA, Fungal; Drug Therapy, Combination; Eye Infections, Fungal; Fusariosis; Fusarium; Glucocorticoids; Humans; Keratomileusis, Laser In Situ; Lasers, Excimer; Male; Myopia; Polymerase Chain Reaction; Postoperative Complications; Povidone-Iodine; Prednisolone; Visual Acuity; Young Adult

To introduce a screening method for diagnosis of photorefractive keratectomy (PRK) in donated whole globes.. Donated whole globes with either no or an unknown history of refractive surgery on family interview were evaluated in the Central Eye Bank of Iran. After disinfection of globes by immersion in 3% povidone iodine for 3 minutes, followed by irrigation with 0.9% normal saline, gross inspection and slit-lamp biomicroscopic examination of the corneas were performed. Corneas with a disciform, round-shaped hazy area within the central 8 mm of the cornea, suggestive of previous PRK (case), and corneas without this criterion (control) were excised and sent for histopathology. Then, sensitivity and specificity of the screening method were calculated by analyzing the histopathology results of case and control corneas.. Twelve thousand five hundred fifty-four donated whole globes from 6832 donors were examined. Twenty case corneas from 10 donors and 54 controls from 27 donors were evaluated by histopathology. Age and sex of the donor population in both case and control groups were comparable with the entire donor population. PRK was confirmed by histopathology in all 20 case corneas but not in any of the control corneas. Both the sensitivity and specificity of this screening method were 100%.. Gross inspection of donated whole globes after exposure to povidone iodine followed by slit-lamp biomicroscopic examination, with particular attention to finding a midperipheral-to-midperipheral disciform hazy area within the central 8 mm of cornea, is a safe, simple, and inexpensive screening method, with high sensitivity and specificity for diagnosing PRK.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cornea; Diagnostic Techniques, Ophthalmological; Eye Banks; False Positive Reactions; Female; Humans; Infant; Male; Middle Aged; Myopia; Photorefractive Keratectomy; Povidone-Iodine; Predictive Value of Tests; Sensitivity and Specificity; Tissue Donors; Young Adult