Aqueous Chlorhexidine Compared with Povidone-Iodine as Ocular Antisepsis before Intravitreal Injection: A Randomized Clinical Trial

Ali, Ferhina S.; Jenkins, Thomas L.; Boparai, Ranjodh S; Obeid, Anthony; Ryan, Martha; Wibblesman, Turner D.; Chiang, Allen; Levin, Hannah; Xu, David; Pandit, Ravi R.; Spirn, Marc J.; Park, Carl; Fineman, Mitchell S.; Vander, J.F.; Mehta, Sonia; Sivalingam, Arunan; Hsu, Jason; Ho, Allen C.; Regillo, Carl D.

doi:10.1016/j.oret.2020.11.008

Cited by 28 publications

(22 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the solutions were alcoholic and contained detergents, unlike the aqueous solutions used to treat fungal keratitis [ 106 , 107 ]. In a large retrospective case series and a randomized clinical trial, in which aqueous CHX was used as an ocular antisepsis prior to intravitreal injections, no toxicity was reported [ 108 , 109 ]. We found one case report in which toxic keratitis associated with the use of the 0.02% solution was suspected [ 110 ].…”

Section: Antisepticsmentioning

confidence: 99%

Fusarium Keratitis—Review of Current Treatment Possibilities

Szaliński

Zgryźniak

Rubisz³

et al. 2021

JCM

View full text Add to dashboard Cite

In many parts of the world, fungi are the predominant cause of infectious keratitis; among which, Fusarium is the most commonly isolated pathogen. The clinical management of this ophthalmic emergency is challenging. Due to the retardation of the first symptoms from an injury and the inability to differentiate fungal from bacterial infections based on clinical symptoms and difficult microbial diagnostics, proper treatment, in many cases, is postponed. Moreover, therapeutical options of Fusarium keratitis remain limited. This paper summarizes the available treatment modalities of Fusarium keratitis, including antifungals and their routes of administration, antiseptics, and surgical interventions.

show abstract

Section: Antisepticsmentioning

confidence: 99%

Fusarium Keratitis—Review of Current Treatment Possibilities

Szaliński

Zgryźniak

Rubisz³

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…A recent prospective study examined 100 eyes of 50 patients, with one eye randomized to aqueous chlorhexidine and the other to povidone-iodine. The results showed that there was no difference in rates between the two groups in terms of endophthalmitis or positive microbial cultures; additionally, the eyes treated with aqueous chlorhexidine reported less ocular discomfort and less corneal epitheliopathy [83,85 ▪ ].…”

Section: Prophylaxis With Topical Antisepticsmentioning

confidence: 93%

Complications of intravitreal injections: 2022

Patel

Chaudhary

2022

Current Opinion in Ophthalmology

Self Cite

View full text Add to dashboard Cite

Purpose of reviewThis review highlights the complications of both intravitreal injection procedure as well as different intravitreal medications including antivascular endothelial growth factors, antibiotics, antivirals, antifungals, methotrexate, and steroids. Techniques for reducing rates of endophthalmitis will also be discussed. Recent findingsIntravitreal vancomycin can cause hemorrhagic occlusive retinal vasculitis resulting in severe vision loss. Intravitreal brolucizumab is associated with intraocular inflammation and retinal vasculitis resulting in significant vision loss. Face mask use by both patient and physician is not associated with increased risk of endophthalmitis and may decrease culture positive endophthalmitis.

show abstract

“…Chlorhexidine is a low-level disinfectant and is used for disinfection of the eye surface in intravitreal injection and also used in persons who are hypersensitive to povidoneiodine [55]. It has the advantages of being transparent, inducing little corneal irritation and having almost no odor [56]. However, when placed on the operating table, its transparent appearance may be mistaken for physiological saline and attention should be paid not to mistakenly inject the solution into the eye.…”

Section: Povidone-iodine As a "Border Control" Measurementioning

confidence: 99%

Cataract Surgery by Intraoperative Surface Irrigation with 0.25% Povidone–Iodine

Shimada

Nakashizuka

2021

JCM

View full text Add to dashboard Cite

Postoperative endophthalmitis after cataract surgery is typically caused by the patient’s own conjunctival normal bacterial flora. A three-step approach is recommended to prevent endophthalmitis: (1) “border control” to prevent microorganisms from entering the eye by disinfecting the ocular surface is the most important measure; (2) bacteria that have gained access into the anterior chamber are reduced by irrigation; (3) bacteria remaining in the anterior chamber and vitreous at the end of surgery are controlled by antibacterial drugs. We have devised a method, “the Shimada technique”, for irrigating the ocular surface with povidone-iodine, a disinfectant with potent microbicidal effect and established effective and safe concentrations for eye tissues. Povidone-iodine exhibits a bactericidal effect for a wide concentration range of 0.005–10%, but 0.1% povidone-iodine has the highest activity and requires the shortest time of only 15 s to achieve microbicidal effect. When used to irrigate the ocular surface every 20–30 s during cataract surgery, 0.25% povidone-iodine is conceivably diluted to around 0.1%. Irrigation with 0.25% povidone-iodine during cataract surgery significantly reduced bacteria contamination rate in the anterior chamber compared with saline (p = 0.0017) without causing corneal endothelial damage.

show abstract

Aqueous Chlorhexidine Compared with Povidone-Iodine as Ocular Antisepsis before Intravitreal Injection: A Randomized Clinical Trial

Cited by 28 publications

References 34 publications

Fusarium Keratitis—Review of Current Treatment Possibilities

Fusarium Keratitis—Review of Current Treatment Possibilities

Complications of intravitreal injections: 2022

Cataract Surgery by Intraoperative Surface Irrigation with 0.25% Povidone–Iodine

Contact Info

Product

Resources

About