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B. Boehmer, D. Neely, M. Koederitz, D. Plager, D. Sprunger, N. Sondhi, G. Roberts; Postoperative Povidone-Iodine Prophylaxis in Strabismus Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4873.
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While antibiotic/steroid combinations are routinely administered during the first week after strabismus surgery, they are costly, inconvenient, and may be unnecessary. The purpose of this study is to evaluate the safety and efficacy of single-dose 5% povidone-iodine drops as a prophylaxis against postoperative infection in extraocular muscle surgery.
Retrospective chart review was performed of 1752 patients undergoing strabismus surgery from January 2002 to June 2006. Patients received either a single application of 5% povidone-iodine solution to the operative eye(s) at the conclusion of the surgical procedure or they received a standard week-long course of topical antibiotic/steroid. If treated with only the single dose of povidone-iodine, patients did not receive any additional postoperative antibiotics or steroids. Postoperative records, including office visits and telephone logs, were then reviewed to identify any abnormalities or complications occurring during the first two months after the strabismus surgery. Abnormalities were defined as any unusual amount of discharge, pain, swelling, or redness. Particular attention was paid to any signs or symptoms that lead to a change in management.
Complete documentation was found for 1502 patients. Single dose povidone-iodine prophylaxis was used in 950 cases (63%), and a topical antibiotic/steroid combination was used in 552 cases (37%). Of the 1502 cases, possible infection occurred in 43 patients (2.86%). Of the 43 possible infections, 17 (3.08%) occurred in 552 patients on an antibiotic/steroid combination, and 26 (2.74%) occurred in the 950 patients treated with single-dose povidone-iodine prophylaxis. This difference was not statistically significant (p=0.7008). No cases of orbital cellulitis or endophthalmitis occurred in either group.
Single-dose povidone-iodine is a safe and inexpensive alternative to postoperative antibiotic/steroid prophylaxis in routine strabismus surgery.
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