Povidone-iodine as an infusion solution for vitrectomy for endophthalmitis of various origins.

Abstract

Background: Povidone iodine ( PI) even in low concentrations (0.01% solution) has a significant bactericidal effect after 15 s of exposure. It has also been proven that the bactericidal effect of a 0.025% solution of PI persists for 15 min at room temperature. The results of a study of the toxicity of povidone iodine to eye tissues showed its safety: usage of a 0.025% solution of PI in a balanced salt solution ( BSS) does not cause damage to the cells of the cornea and retina. Preoperative 0.1 ml of a 0.25% solution of PI intravitreal before vitrectomy demonstrated not only high efficiency, but also safety, as evidenced by improvement of visual acuity and oscillatory potentials on the ERG in patients after endophthalmitis. The aim of our work was to study the eff ectiveness of the bactericidal effect during irrigation with 0.025 % PI in a BSS during vitrectomy for the treatment of endophthalmitis of various origins. Methods: A retrospective study of 13 cases of endophthalmitis was performed: 7 patients after penetrating wounds, one patient after secondary IOL implantation, one patient after cataract phacoemulsification with IOL, three patients after intravitreal anti-VEGF injection, one patient with IOL haptic extrusion. All patients underwent a standard set of tests. anterior chamber washout was performed in 13 patients, lensectomy in 7 patients. All patients underwent vitrectomy using 0.025% PI solution as irrigation fluid. Results: Proposed technique allowed in all cases to achieve a positive result in the treatment of endophthalmitis with the achievement of retinal reattachment in 12 patients. In one case, fungal post-traumatic endophthalmitis occurred, which required additional intravitreal administration of amphotericin B. No side eff ects were noted. Findings: The use of 0.025% povidone-iodine in BSS as an irrigation fl uid for vitrectomy is a safe and eff ective treatment for endophthalmitis of various origins.