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Povidone-iodine may have led to decrease in postoperative endophthalmitis over 20 years
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Preoperative povidone-iodine treatment may be a contributing factor in the decrease of postoperative endophthalmitis over a 20-year period, according to a study.
Seventy-seven out of 68,323 patients (0.113%) who underwent intraocular surgeries at a single institution developed postoperative endophthalmitis in a 20-year period.
Three periods were established for data analysis due to changes in preoperative prophylaxis. There was no standardized prophylaxis regimen in period 1 (1990 to 1992), preoperative topical povidone-iodine 10% was given periorbitally with one drop of povidone-iodine 1% in the conjunctival sac in period 2 (1993 to 1998), and the same regimen as period 2 was given in period 3 (1999 to 2009) except with irrigation of the conjunctival sac with 10 mL povidone-iodine 1%.
The rate of postoperative endophthalmitis decreased over a 20-year period, and the rate was lowest in period 3. The rate of postoperative endophthalmitis in intraocular surgeries was 0.291% in period 1, 0.170% in period 2 and 0.065% in period 3.
The postoperative endophthalmitis rate after cataract surgery was 0.338% in period 1, 0.224% in period 2 and 0.041% in period 3. The overall rate of postoperative endophthalmitis was 0.125% in all cataract surgeries.
"Although multiple factors might have contributed to this decline, implementation of a preoperative prophylaxis protocol that used copious povidone-iodine could be the most important measure," the study authors said. - by Nhu Te
Disclosure: The study authors report no relevant financial disclosures.
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