Intraocular Povidone Iodine During Pars Plana Vitrectomy for Severe and Atypical Endophthalmitis

BACKGROUND AND OBJECTIVE: To describe the experience and clinical outcomes of povidone iodine (PI) infusion in the setting of pars plana vitrectomy for the treatment of endophthalmitis. MATERIALS AND METHODS: This was a retrospective case series of 12 patients with clinical and/or culture evidence of endophthalmitis requiring pars plana vitrectomy with 0.025% PI used in vitreous irrigation solution during vitrectomy. The primary endpoint was clinical resolution of the infection. Secondary endpoints included visual recovery, need for repeat surgery, and ocular toxicity RESULTS: There were 11 eyes that showed clinical or culture evidence of resolution of infection postoperatively (91.7%); 10 eyes had improvement in vision postoperatively (83.3%). Overall uncorrected visual acuity improved from 20/5321 (2.43 +/- 0.58 logMAR) to 20/375 (1.27 +/- 1.05 logMAR) (P =.0003). No clinical evidence of ocular toxicity or unexplained vision loss due to PI was observed. CONCLUSIONS: PI infusion during pars plana vitrectomy for endophthalmitis appears safe and led to excellent post-surgical results in a traditionally high-risk cohort.

Automated summary

The infusion of povidone iodine during pars plana vitrectomy for endophthalmitis showed safe and effective clinical outcomes, with improvement in visual acuity and minimal ocular toxicity observed.