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Combination treatment during vitrectomy may prevent endophthalmitis
Retina. 2010;30(8):1242-1249.
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Povidone-iodine irrigation, angled-incision sclerotomy and vitreous perfusion can prevent bacterial contamination of the vitreous during 25-gauge vitrectomy surgery, a prospective study found.
"In 25-G vitrectomy, irrigation of the operative field with dilute povidone-iodine at the beginning of surgery, ample irrigation with infusion fluid during surgery, creation of sclerotomies using angled incisions, and adequate vitreous perfusion are important infection control measures," the study authors wrote.
Investigators evaluated a total of 4,347 eyes undergoing 25-gauge vitrectomy. Specifically, 2,801 eyes were irrigated with infusion fluid and 1,546 eyes were irrigated with 1.25% povidone-iodine.
Bacteriologic culture was performed for 103 eyes in the irrigation group and 155 eyes in the povidone-iodine group.
The bacterial contamination rate after lid speculum placement did not differ significantly between the groups, according to the study. However, contamination rates in ocular surface fluid collected after irrigation and in vitreous collected after angled incision and at the completion of vitrectomy were lower in eyes that received povidone-iodine than in eyes that underwent irrigation with infusion fluid.
There was no incidence of endophthalmitis in either group.