Chu L Nguyen1,2, Lawrence J Oh1, Eugene Wong1, Ian C Francis1. 1. Department of Ophthalmology, Prince of Wales Hospital, Sydney - Australia. 2. Department of Ophthalmology, Chatswood Private Hospital, Chatswood, Sydney - Australia.
Abstract
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.
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.
Authors: Carlo Contini; Carla Enrica Gallenga; Giampiero Neri; Martina Maritati; Pio Conti Journal: Med Hypotheses Date: 2020-05-24 Impact factor: 1.538