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

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.

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

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.

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

2011 ◽  
Vol 151 (1) ◽  
pp. 11-17.e1 ◽  
Author(s):  
Hiroyuki Shimada ◽  
Shinzi Arai ◽  
Hiroyuki Nakashizuka ◽  
Takayuki Hattori ◽  
Mitsuko Yuzawa
Keyword(s):  
Cataract Surgery ◽  
Anterior Chamber ◽  
Povidone Iodine ◽  
Contamination Rate ◽  
Surface Irrigation

Povidone-Iodine 3-Minute Exposure Time is Viable in Preparation for Cataract Surgery

2017 ◽  
Vol 27 (5) ◽  
pp. 573-576 ◽  
Author(s):  
Chu L. Nguyen ◽  
Lawrence J. Oh ◽  
Eugene Wong ◽  
Ian C. Francis
Keyword(s):  
Clinical Practice ◽  
Cataract Surgery ◽  
Exposure Time ◽  
Ocular Surface ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Minute Exposure ◽  
Visual Outcomes ◽  
Preoperative Prophylaxis ◽  
Operating Room Staff

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.

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

2019 ◽  
Vol 62 (3) ◽  
pp. 166-172 ◽  
Author(s):  
Fang Fan ◽  
Zhihua Zhao ◽  
Xiaobin Zhao ◽  
Qingmin Ma ◽  
Kejun Li ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Ocular Surface ◽  
Povidone Iodine ◽  
Surface Damage ◽  
Bacterial Survival ◽  
Surface Irrigation

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

Eye ◽  
2011 ◽  
Vol 25 (11) ◽  
pp. 1526-1526 ◽  
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

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

Eye ◽  
2011 ◽  
Vol 25 (11) ◽  
pp. 1423-1428 ◽  
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

scholarly journals Efficacy of 0.5% Levofloxacin and 5.0% Povidone-Iodine Eyedrops in Reducing Conjunctival Bacterial Flora: Metagenomic Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Caixia Fan ◽  
Baoxia Yang ◽  
Yusen Huang
Keyword(s):  
Cataract Surgery ◽  
High Throughput Sequencing ◽  
Povidone Iodine ◽  
Therapy Group ◽  
Bacterial Species ◽  
Bacterial Flora ◽  
Metagenomic Analysis ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Bacteria associated with postoperative endophthalmitis mostly originate from the normal bacterial flora of the patient’s conjunctiva and eyelids, so the incidence of endophthalmitis may be reduced by eliminating the ocular and adnexal flora before surgery. We assessed the effectiveness of eyedrops of 0.5% levofloxacin and 5.0% povidone-iodine (PVI) in reducing conjunctival bacterial flora by metagenomic analysis. A total of 2.4 × 106 high-quality sequencing reads were generated from 93 conjunctival samples obtained from 31 eyes scheduled for cataract surgery before prophylactic therapy (group 1), after administration of 0.5% levofloxacin eyedrops into the conjunctival sac 8 times before surgery (group 2), and at 3 minutes after instillation of 5.0% PVI solution in the conjunctival sac (group 3) followed by surgery irrigation. The alpha diversity and beta diversity results demonstrated that group 3 had the least richness and biodiversity. Corynebacterium, Pseudomonas, Staphylococcus, Acinetobacter, and Streptococcus were predominant in all samples. The relative abundance of these bacterial species was 30.94%, 27.48%, 5.26%, 4.55%, and 2.61% in group 1, 16.32%, 44.10%, 2.19%, 5.39%, and 0.97% in group 2, and 5.90%, 65.55%, 0.39%, 5.36%, and 0.10% in group 3, respectively. The most easily and difficultly eliminated were Corynebacterium and Pseudomonas, respectively. In conclusion, the metagenomic analysis using high-throughput sequencing provides a scientific way for evaluating the effectiveness of a disinfection method from the perspective of analyzing the composition and diversity of the conjunctival microbiome. Despite the use of preoperative antisepsis regimens, the ocular surface of patients receiving cataract surgery could not be rendered completely aseptic, indicating that more strict disinfection methods need to be adopted to reduce the risk for anterior chamber contamination and endophthalmitis after cataract surgery.

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