Reduction of Ocular Surface Damage and Bacterial Survival Using 0.05% Povidone-Iodine Ocular Surface Irrigation before Cataract Surgery

Purpose Povidone-iodine (PI) is widely used to reduce the preoperative conjunctival bacterial load. This study aimed to evaluate the employment of PI 10% in an attempt to sterilize the ocular surface prior to cataract surgery, and to show that PI could be left in contact for 3 minutes. The viability of this exposure time in clinical practice, associated adverse events, and visual outcomes were documented. Methods In this prospective cohort study, phacoemulsification cataract surgery was performed in 604 patients by a single surgeon. Preoperative preparation was undertaken with PI 10%, applied to the cornea, conjunctival sac, eyelids, and periorbital skin with sterile cotton gauze. Povidone-iodine was then flushed onto the ocular surface. Operating room staff timed the precise duration of exposure. After the 3-minute preparation, the lids were thoroughly dried with fresh dry gauze. Results The median PI exposure time was 3.17 minutes, with an interquartile range of 0.25. All cases were followed up postoperatively at 1 day, 1 week, and 1 month. There were no complications attributable to PI. Visual outcomes were satisfactory. Conclusions Implementation of a preoperative prophylaxis protocol that used PI 10% with a 3-minute exposure time can be performed in clinical practice. The 3-minute exposure time had no adverse sequelae.

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Effectiveness of 0.66% Povidone-Iodine Eye Drops on Ocular Surface Flora before Cataract Surgery: A Nationwide Microbiological Study

Journal of Clinical Medicine ◽

10.3390/jcm10102198 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2198

Author(s):

Rosario Musumeci ◽

Pasquale Troiano ◽

Marianna Martinelli ◽

Matteo Piovella ◽

Claudio Carbonara ◽

...

Keyword(s):

Cataract Surgery ◽

Ocular Surface ◽

Povidone Iodine ◽

Bacterial Species ◽

Bacterial Flora ◽

Bacterial Load ◽

Controlled Study ◽

Eye Drops ◽

Microbiological Analysis ◽

Contralateral Eye

A multicenter, nonrandomized, prospective, controlled study was conducted to evaluate, as perioperative prophylactic treatment, the anti-infective effectiveness of 0.66% povidone-iodine eye drops (IODIM®) against the bacterial flora of the conjunctival surface of patients who undergo cataract surgery. Eye drops containing 0.66% povidone-iodine were applied to the eye undergoing cataract surgery; the untreated contralateral eye was used as control. One hundred and twenty patients set to receive unilateral cataract surgery were enrolled in 5 Italian Ophthalmology Centers and pretreated for three days with 0.66% povidone-iodine eye drops. The contralateral eye, used as control, was left untreated. Conjunctival swabs of both eyes were collected at the baseline visit and after three days of treatment, just before the cataract surgery. A qualitative and quantitative microbiological analysis of bacterial presence was evaluated by means of bacterial culture, followed by identification. Methicillin resistance determination was also performed on staphylococci isolates. Bacterial load before and after treatment of the eye candidate for cataract surgery was evaluated and compared to the untreated eye. A reduction or no regrowth on the culture media of the bacterial load was observed in 100% of the study subjects. A great heterogenicity of bacterial species was found. The 0.66% povidone-iodine eye drops, used for three days prior to cataract surgery, were effective in reducing the conjunctival bacterial load. The 0.66% povidone-iodine eye drops (IODIM®) might represent a valid perioperative prophylactic antiseptic adjuvant treatment to protect the ocular surface from microbial contamination in preparation of the surgical procedure.

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Reducing bacterial contamination inside fluid catch bag in 25-gauge vitrectomy by use of 0.25 % povidone-iodine ocular surface irrigation

International Ophthalmology ◽

10.1007/s10792-012-9621-6 ◽

2012 ◽

Vol 33 (1) ◽

pp. 35-38 ◽

Cited By ~ 1

Author(s):

Hiroyuki Shimada ◽

Hiroyuki Nakashizuka ◽

Takayuki Hattori ◽

Yorihisa Kitagawa ◽

Ayumu Manabe ◽

...

Keyword(s):

Ocular Surface ◽

Bacterial Contamination ◽

Povidone Iodine ◽

Surface Irrigation ◽

25 Gauge Vitrectomy

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Reduction of Anterior Chamber Contamination Rate After Cataract Surgery by Intraoperative Surface Irrigation With 0.25% Povidone–Iodine

American Journal of Ophthalmology ◽

10.1016/j.ajo.2010.07.002 ◽

2011 ◽

Vol 151 (1) ◽

pp. 11-17.e1 ◽

Cited By ~ 46

Author(s):

Hiroyuki Shimada ◽

Shinzi Arai ◽

Hiroyuki Nakashizuka ◽

Takayuki Hattori ◽

Mitsuko Yuzawa

Keyword(s):

Cataract Surgery ◽

Anterior Chamber ◽

Povidone Iodine ◽

Contamination Rate ◽

Surface Irrigation

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Erratum: Survival of bacteria on the ocular surface following double application of povidone-iodine before cataract surgery

Eye ◽

10.1038/eye.2011.216 ◽

2011 ◽

Vol 25 (11) ◽

pp. 1526-1526 ◽

Cited By ~ 1

Author(s):

C V Stranz ◽

G E Fraenkel ◽

A R Butcher ◽

A J Esterman ◽

M J Goggin

Keyword(s):

Cataract Surgery ◽

Ocular Surface ◽

Povidone Iodine

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Survival of bacteria on the ocular surface following double application of povidone-iodine before cataract surgery

Eye ◽

10.1038/eye.2011.182 ◽

2011 ◽

Vol 25 (11) ◽

pp. 1423-1428 ◽

Cited By ~ 7

Author(s):

C V Stranz ◽

G E Fraenkel ◽

A R Butcher ◽

A J Esterman ◽

M J Goggin

Keyword(s):

Cataract Surgery ◽

Ocular Surface ◽

Povidone Iodine

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Faculty Opinions recommendation of Reduction of anterior chamber contamination rate after cataract surgery by intraoperative surface irrigation with 0.25% povidone-iodine.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.12565957.13800055 ◽

2011 ◽

Author(s):

William Myers

Keyword(s):

Cataract Surgery ◽

Anterior Chamber ◽

Povidone Iodine ◽

Contamination Rate ◽

Surface Irrigation

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Cataract Surgery by Intraoperative Surface Irrigation with 0.25% Povidone–Iodine

Journal of Clinical Medicine ◽

10.3390/jcm10163611 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3611

Author(s):

Hiroyuki Shimada ◽

Hiroyuki Nakashizuka

Keyword(s):

Cataract Surgery ◽

Anterior Chamber ◽

Ocular Surface ◽

Povidone Iodine ◽

Bacterial Flora ◽

Bactericidal Effect ◽

Endothelial Damage ◽

Contamination Rate ◽

Eye Tissues ◽

Normal Bacterial Flora

Postoperative endophthalmitis after cataract surgery is typically caused by the patient’s own conjunctival normal bacterial flora. A three-step approach is recommended to prevent endophthalmitis: (1) “border control” to prevent microorganisms from entering the eye by disinfecting the ocular surface is the most important measure; (2) bacteria that have gained access into the anterior chamber are reduced by irrigation; (3) bacteria remaining in the anterior chamber and vitreous at the end of surgery are controlled by antibacterial drugs. We have devised a method, “the Shimada technique”, for irrigating the ocular surface with povidone-iodine, a disinfectant with potent microbicidal effect and established effective and safe concentrations for eye tissues. Povidone-iodine exhibits a bactericidal effect for a wide concentration range of 0.005–10%, but 0.1% povidone-iodine has the highest activity and requires the shortest time of only 15 s to achieve microbicidal effect. When used to irrigate the ocular surface every 20–30 s during cataract surgery, 0.25% povidone-iodine is conceivably diluted to around 0.1%. Irrigation with 0.25% povidone-iodine during cataract surgery significantly reduced bacteria contamination rate in the anterior chamber compared with saline (p = 0.0017) without causing corneal endothelial damage.

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Prophylaxis for acute scleral buckle infection using 0.25 % povidone-iodine ocular surface irrigation during surgery

International Ophthalmology ◽

10.1007/s10792-013-9816-5 ◽

2013 ◽

Vol 34 (2) ◽

pp. 211-216 ◽

Cited By ~ 4

Author(s):

Hiroyuki Shimada ◽

Hiroyuki Nakashizuka ◽

Takayuki Hattori ◽

Kyuen Otani ◽

Ayumu Manabe ◽

...

Keyword(s):

Ocular Surface ◽

Povidone Iodine ◽

Scleral Buckle ◽

Surface Irrigation ◽

Buckle Infection

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SOME QUESTIONS ABOUT THE STATE OF THE EYE SURFACE IN PATIENTS BEFORE CATARACT SURGERY

Modern medical technologies ◽

10.34287/mmt.3(46).2020.4 ◽

2020 ◽

Vol 46 (3) ◽

pp. 21

Author(s):

N. S. Lutsenko ◽

O. A. Isakova ◽

O. A. Rudycheva ◽

T. S. Kyrilova ◽

T. S. Mihalchik

Keyword(s):

Diabetes Mellitus ◽

Cataract Surgery ◽

Ocular Surface ◽

Life Quality ◽

Surface Damage ◽

Ocular Surgery ◽

Body Sensation ◽

Patients With Diabetes ◽

Break Up ◽

Corneal Staining

Introduction. Ocular surface status is a main risk factor for the development of postoperative complications and lead to the decrease of life quality. Purpose of the study.The condition of the surface of the eye in patients before cataract surgery was study. Material and methods. 320 patients preoperative the cataract surgery were investigated, among them 172 patients were female, 148 – were male. Patients with any previous ocular surgery or concomitant ocular diseases were excluded. The structure of common non-ocular comorbidities, subjective signs of ocular surface damage (redness, foreign body sensation, dryness, burning) and objective symptoms (tear break up time, cornea fluorescein staining) were carried out. Patients with asymptomatic forms of cornea staining were identified. Results. It was found that 100 patients (31,2%) had subjective signs (specific complains) of ocular surface damage and 135 patients (35,5%) had positive corneal staining. Specific complains and obvious ocular surface damage were revealed in 17,7% and latent ocular surface damage – in 16,9% of patients. Thus 49% of patients had asymptomatic form of ocular surface damage. In the group of patients with diabetes mellitus healthy ocular surface was observed only in 35,6% cases, asymptomatic form of ocular surface damage consisted 72,9% and obvious damage – 16,9% among all patients. Conclusion. Ocular surface dysfunction is common among patients before cataract surgery, especially in diabetes mellitus. Clinicians should be aware of this high prevalence and consider ocular surface screening before cataract surgery. Keywords. Ocular surface damage, cataract, tear break up time, fluorescein corneal staining.

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