Related Experiment Video
Updated: Apr 22, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Paediatric Strabismus Surgery: a Retrospective Analysis of Different Postoperative Treatment Regimes to Prevent
Maryam Missu1,2, Daniel Felber1,2, Anja Palmowski-Wolfe1,2
1Faculty of Medicine, University of Basel, Switzerland.
Insights
A single dose of povidone iodine (PVI) is as effective as a week of antibiotic eye drops for preventing infections after pediatric strabismus surgery. This PVI regimen offers a safe and cost-effective alternative, reducing antibiotic resistance and patient burden.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Infectious Disease Prevention
Background:
- Povidone iodine (PVI) demonstrates superior antibacterial properties compared to topical antibiotics.
- A shift from a one-week antibiotic regimen to single-dose PVI post-strabismus surgery was implemented in 2017.
- Adult studies showed no significant difference in infection rates or healing, but pediatric populations require separate evaluation due to immature immune systems.
Purpose of the Study:
- To compare the efficacy of topical antibiotics versus single-dose PVI in preventing postoperative infections following pediatric strabismus surgery.
- To evaluate secondary outcomes including conjunctival swelling, redness, corneal healing, and anterior chamber/vitreous inflammation.
Main Methods:
- A retrospective analysis of pediatric patients undergoing strabismus surgery before and after the treatment change.
- Data collected at 7 days and 3 months postoperatively.
- Statistical comparison using Fisher's exact test or Mann-Whitney U test (p < 0.05 significance).
Main Results:
- 152 children were analyzed: 85 received a week of antibiotics (G1) and 67 received single-dose PVI (G2).
- No significant difference in bacterial conjunctivitis rates (4.7% in G1 vs. 2.9% in G2, p > 0.05).
- No significant differences observed in secondary endpoints (swelling, redness, healing, inflammation) between groups.
Conclusions:
- Single-dose topical PVI is an effective and safe alternative for postoperative infection prophylaxis in pediatric strabismus surgery.
- This approach avoids increased infection rates or prolonged healing times.
- PVI reduces antibiotic resistance development and lessens the treatment burden on children and parents.
Abstract:
BACKGROUND: Povidone iodine (PVI) has been reported to surpass topical antibiotics in antibacterial effectiveness. Consequently, we changed the regimen post strabismus surgery in 2017 from a one-week course of topical antibiotic eye drops to PVI given once at the end of surgery. In an adult population, this resulted in no significant change in infection rate and healing. In paediatric patients, the immune system is not mature and children may be exposed to different pathogens. Therefore, the aim of this study was to evaluate these two regimens in regard to their efficacy to prevent infections post strabismus surgery in children.
Abstract:
PATIENTS AND METHODS: In this retrospective and exploratory study, data from paediatric patients with strabismus surgery before and after this change in postoperative treatment were analysed. Information was taken from routine follow-up visits on postoperative days 7 and at 3 months. Primary endpoint was the postoperative incidence of bacterial conjunctivitis. Secondary endpoints were conjunctival swelling and redness, corneal wound healing and presence of cells in the anterior chamber or vitreous body. Statistical analysis was performed using Fisher's exact test or the Mann-Whitney U test. p < 0.05 was considered significant.
Abstract:
RESULTS: 152 patients were included. 85 children (G1) had received aminoglycoside eye drops 3×/day for 1 week following strabismus surgery and 67 children (G2) had received a single-dose of topical PVI immediately at the end of surgery. Average age in G1 was 8.2 (SD 4.5; range 1 - 17) years and in G2 was 7.4 (SD 3.9; range 2 - 17) years. There was no statistically significant difference in the surgical procedure performed (type of surgery, reoperations, duration of the surgery). Bacterial conjunctivitis was documented in 4.7% in G1 and 2.9% in G2 (p > 0.05). There was also no significant difference for any of the secondary endpoints analysed at any of the two regular follow-up dates.
Abstract:
CONCLUSIONS: Postoperative infection prophylaxis with a single administration of topical PVI is an efficient alternative to topical antibiotics in a paediatric population, without more frequent infections or longer healing. This cost-efficient alternative minimises development of resistance to antibiotics and puts less burden on parents and children, as less treatment needs to be applied.
More Related Videos
Related Concept Videos
01:26Tonsillitis II: Management
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:28Angle Closure Glaucoma: Treatment
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...