Povidone-Iodine and Prevention of Endophthalmitis


New treatments for eye diseases, such as diabetic retinopathy, retinal vein occlusions, and choroidal neovascularization have in recent years led to an increase in intravitreal injections. An article in Retinal Physician states: “Despite a low incidence of endophthalmitis following intravitreal injections, the prevalence of endophthalmitis is rising due to the sheer volume of intravitreal injections being performed today compared to 10 years ago.”(1)

Endophthalmitis, an infection of the fluids or tissues inside the eye, is a medical emergency that requires immediate medical treatment. It can cause blindness if not treated promptly.(2)

A number of studies have shown the effectiveness of Povidone-Iodine in preventing endophthalmitis when applied before intravitreal injections as a well as before cataract surgery. A study published in Ophthalmology Retina, which involved 37,646 intravitreal injections, concluded: “The application of PI after placement of the lid speculum reduced the incidence of endophthalmitis occurring after injection approximately 7-fold compared with other aseptic protocols.”(3)

A study conducted at Leeds Teaching Hospital evaluated the effectiveness of three minutes of 5% povidone-iodine for skin and conjunctival antisepsis prior to cataract surgery. The study included 54 patients. “The eye undergoing surgery was prepared with 5% povidone-iodine for three minutes,” while the other eye served as control. Both eyes were swabbed afterwards. “Use of 5% povidone-iodine for three minutes resulted in a statistically significant reduction in proportion of culture-positive swabs,” the study found. The use of the povidone-iodine achieved a significant reduction in organisms such as CoNS from lid and conjunctival flora.(4)

For qualified providers, Edge offers Povidone Iodine 5% in a single use, 0.5 mL syringe. Visit to easily set up an account and order.

(1) Starr, M. M.D., Bakri, S. M.D., Retinal Physician, Reducing Endophthalmitis Risk Following Intravitreal Injections: What Really Works? https://www.retinalphysician.com
(2) Mukamal, R. American Academy of Ophthalmology, What is Endophthalmitis? https://www.aao.org/eye-health
(3) Levinson, J. M.D., Garfinkel, R. M.D., et. al., Ophthalmology Retina, Timing of Povidone-Iodine Application to Reduce the Risk of Endophthalmitis, https://www.ophthalmologyretina.org/ (pdf)
(4) Carrim, Zia, European Journal of Ophthalmology, online article, The Efficacy of 5% Povidone-Iodine for Three Minutes Prior to Cataract Surgery, https://www.researchgate.net/publication

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