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Review
. 2022 Jan 1;33(1):28-34.
doi: 10.1097/ICU.0000000000000817.

Low-concentration povidone-iodine for the prevention of intraocular infections in ophthalmic surgery

Andrzej Grzybowski  1   2 , Hiroyuki Shimada  3 , Hiroyuki Nakashizuka  3 , Jagger Koerner  4
Affiliations
Review

Low-concentration povidone-iodine for the prevention of intraocular infections in ophthalmic surgery

Andrzej Grzybowski et al. Curr Opin Ophthalmol. .

Abstract

Purpose of review: Endophthamitis following intraocular surgery is rare using current antiseptic techniques, such as single application of 5% povidone-iodine to the ocular surface and adjuvant topical or intracameral antibiotics. Challenges remain, however, including increased multidrug-resistant bacterial endophthalmitis, increased fungal endophthalmitis, and the low but nonzero endophthalmitis rate attributable to the typical bacteria that colonize the ocular surface.

Recent findings: Povidone-iodine has a wide spectrum of activity, including activity against novel pathogens, such as SARS-CoV-2. Povidone-iodine alternatives, such as hypochlorous acid can have significantly less efficacy in vitro against endophthalmitis isolates. Repetitive application of dilute povidone-iodine has an excellent safety profile and strong evidence base for efficacy.

Summary: Povidone-iodine is widely available, inexpensive, and commonly used by ophthalmologists. The repetitive application of dilute povidone-iodine is a well studied, well tolerated, and efficacious way to transiently sterilize the ocular surface during intraocular surgery. Additional benefits include activity against multidrug-resistant bacteria, fungi, and lack of inducible resistance.

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References

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