Postoperative povidone-iodine prophylaxis in strabismus surgery

Area of Science:

• Ophthalmology
• Surgical Infection Prophylaxis

Background:

• Routine strabismus surgery often involves a week-long course of antibiotic/steroid drops post-operation.
• This regimen can be expensive and inconvenient for patients.
• Alternative prophylactic measures are being explored to optimize patient care and reduce costs.

Purpose of the Study:

• To compare the efficacy of single-dose 5% povidone-iodine drops versus a week-long course of topical antibiotic/steroid in preventing postoperative infections after strabismus surgery.
• To evaluate the cost-effectiveness and convenience of povidone-iodine prophylaxis.
• To identify patient subgroups that may benefit more from specific prophylactic treatments.

Main Methods:

• A retrospective chart review of 1871 patients undergoing strabismus surgery was conducted.
• Patients received either single-dose 5% povidone-iodine or a week-long antibiotic/steroid regimen.
• Postoperative records were analyzed for complications within the first two months.

Main Results:

• Data from 1603 patients were analyzed; 59.5% received povidone-iodine and 40.5% received antibiotic/steroid.
• Overall possible infection rate was 2.87% (46/1603).
• Infection rates were similar between groups (2.83% for povidone-iodine vs. 3.08% for antibiotic/steroid), with no statistical significance (p=0.6815). Orbital cellulitis and endophthalmitis were absent in both groups.

Conclusions:

• Single-dose povidone-iodine is a safe and inexpensive alternative for prophylaxis after routine strabismus surgery via fornix incision.
• Patients undergoing reoperations or those with limbal incisions may experience more complicated postoperative courses.
• Continued use of antibiotic/steroid combinations may be beneficial for specific high-risk patient groups.