Reduction of Anterior Chamber Contamination Rate After Cataract Surgery by Intraoperative Surface Irrigation With 0.25% Povidone-Iodine
Reduction of Anterior Chamber Contamination Rate After Cataract Surgery by Intraoperative Surface Irrigation With 0.25% Povidone-Iodine
复制标题
DOI：
10.1016/j.ajo.2010.07.002
复制
发表时间：
2011-01-01
影响因子：
4.2
通讯作者：
Yuzawa, Mitsuko
中科院分区：
文献类型：
--
作者：
Shimada, Hiroyuki;Arai, Shinzi;Yuzawa, Mitsuko
目得：为了证明在白内障手术过程中，用0.25%聚维酮碘重复冲洗术野可降低手术完成时前房细菌污染率的假设。设计：前瞻性，干预性病例系列。在404只连续眼中，202只眼（A组）用输液冲洗术野，202只眼（B组）用0.25%聚维酮碘冲洗术野。使用以下样本进行细菌学培养：睑窥器放置后的眼表液和手术完成时的前房液。在手术开始和完成时采集前房液样本用于碘离子浓度测量。结果：A、B组眼表液细菌检出率分别为5.5%、6.0%，两组差异无统计学意义; B组眼表液细菌检出率为0%，A组眼表液细菌检出率为5.0%，两组差异有统计学意义（P = 0.0017）。B组手术开始和结束时的碘离子浓度分别为7.5 +/- 0.7 μ g/mL和3.5 +/- 0.7 μ g/mL，A组手术开始和结束时的碘离子浓度均小于0.1 μ g/mL。术前A、B组角膜内皮细胞密度无显著性差异（2614 +/- 233/mm（2）vs 2534 +/- 173/mm（2）; P = .2254）和术后7天（2463 +/- 269/mm（2）vs 2338 +/- 204/mm（2）; P = .4044）。结论：在白内障手术中，用浓度为0.25%的聚维酮碘重复冲洗术野在手术完成时前房中实现了极低的细菌污染率。(Am J Ophthalmol 2011;151：11-17. (c)2011年，Elsevier Inc.版权所有© 2016
PURPOSE: To prove the hypothesis that during cataract surgery, repeated irrigation of the operative field with povidone iodine of 0.25% reduces the anterior chamber bacterial contamination rate at completion of operation.DESIGN: Prospective, interventional case series.METHODS: In 404 consecutive eyes, the operative field was irrigated with infusion fluid in 202 eyes (group A) and with 0.25% povidone iodine in 202 eyes (group B). Bacteriologic culture was performed using the following samples: ocular surface fluid after lid speculum placement and anterior chamber fluid at the completion of surgery. Anterior chamber fluid samples were collected at the beginning and completion of surgery for iodide ion concentration measurement. Corneal endothelial cell density was measured using a specular microscope before surgery and on day 7 after surgery.RESULTS: Bacterial detection rate in ocular surface fluid was not significantly different between group A (5.5%) and group B (6.0%), but the rate in anterior chamber fluid was significantly (P = .0017) reduced in group B (0%) compared with group A (5.0%). Iodide ion concentrations at the start and end of surgery were 7.5 +/- 0.7 mu g/mL and 3.5 +/- 0.7 mu g/mL, respectively, in group B and less than 0.1 mu g/mL both at the start and end of surgery in group A. Corneal endothelial cell densities were not significantly difference between groups A and B before surgery (2614 +/- 233/mm(2) vs 2534 +/- 173/mm(2); P = .2254) and 7 days after surgery (2463 +/- 269/mm(2) vs 2338 +/- 204/mm(2); P = .4044).CONCLUSIONS: In cataract surgery, repeated irrigation of the operative field with povidone iodine at a concentration of 0.25% achieved an extremely low bacterial contamination rate in the anterior chamber at the completion of surgery. (Am J Ophthalmol 2011;151: 11-17. (c) 2011 by Elsevier Inc. All rights reserved.)