Capsular bag irrigation using 0.025% povidone-iodine in balanced salt solution PLUS for the treatment of postoperative endophthalmitis.

We examined the effectiveness and adverse events of using balanced salt solution (BSS) PLUS containing 0.025% povidone-iodine, a non-oculotoxic concentration, for capsular bag irrigation in a case of endophthalmitis mainly involving the anterior chamber. A 57-year-old female underwent cataract surgery and developed hypopyon on day 3 after surgery, with mainly anterior chamber inflammation. The capsular bag was irrigated with BSS PLUS containing 0.025% povidone-iodine. Gram-negative rods were detected from the anterior chamber fluid. Post-procedural visual acuity was 24/20. In a case, endophthalmitis was resolved and there were no adverse events. With the recent increase in multidrug-resistant bacteria, use of 0.025% povidone-iodine in BSS PLUS for anterior chamber irrigation is expected to be useful.

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

To investigate whether repeated washing of the ocular surface with 0.25 % povidone-iodine during scleral buckling surgery minimizes ocular surface bacterial contamination at completion of the procedure. A total of 489 consecutive eyes that underwent scleral buckling at a single institution were categorized into two groups according to the intraoperative ocular surface washing method used during two separate time periods--a group using physiological saline (saline group, 222 consecutive eyes) and a group using 0.25 % povidone-iodine (PI group 267, consecutive eyes). In 37 eyes of each group, ocular surface fluids were sampled at the beginning of surgery and at completion of buckling, and subjected to bacteriological culture. Acute scleral buckle infection occurred in one patient, and was caused by Pseudomonas aeruginosa. The incidence of acute scleral buckle infection was 0.45 % (1/222 eyes) in the saline group, and 0 % in the PI group, with no significant difference (P = 0.4540). The bacterial detection rates in ocular surface fluid at the beginning of surgery were 5.4 % (2/37 eyes) using saline and 8.1 % (3/37 eyes) using povidone-iodine, with no significant difference (P = 0.6433). The rates at completion of buckling were 18.9 % (7/37 eyes) using saline and 0 % (0 eye) using povidone-iodine, with a significant difference (P = 0.0114). Repeated washing of the ocular surface with 0.25 % povidone-iodine during scleral buckling procedure reduced the ocular surface bacterial contamination rate to an extremely low level at completion of buckling, suggesting that this method is useful for the prevention of acute scleral buckle infection.