Safety of Ozonated Solution as an Antiseptic of the Ocular Surface prior to Ophthalmic Surgery

Abstract

Purpose: To evaluate the safety of an ozonated solution as an antiseptic of the ocular surface prior to ophthalmic surgery. Methods: In experiment 1, a primary culture of rabbit corneal epithelium was established. Then, 0, 4 and 10 ppm ozonated solution and 1.25% povidone-iodine, respectively, were applied to confluent cells on collagen-coated filter inserts (Millicell-CM^®) for 10 min followed by replacement with fresh medium. The transepithelial electrical resistance (TER), which is a good indicator of cell barrier function, was sequentially measured for 30 min. In experiment 2, adult pigmented rabbit eyes were washed with 20 ml of 4 ppm ozonated solution, 1.25% povidone-iodine solution or saline. Slitlamp examinations were performed before and after washing. Results: In experiment 1, 4 ppm ozonated solution did not change the TER as compared with the control. 10 ppm ozonated solution and 1.25% povidone-iodine similarly reduced the TER values significantly as compared with those of the control and 4 ppm ozonated solution. In experiment 2, 4 ppm ozonated solution and saline showed mild superficial punctate keratitis (SPK) in 8.3% of eyes. However, 1.25% povidone-iodine resulted in mild SPK in 17% of eyes and moderate SPK in 25% of eyes. The prevalence of SPK between two groups was significantly different (p = 0.03). Conclusion: Ozonated solution may be safe and a useful antiseptic of the ocular surface prior to ophthalmic surgery.

Prevention of postcataract endophthalmitis

“…The most common concentration of 5% is generally recommended [33][34][35][36][37]. Although there is demonstration of the toxicity of povidone-iodine in animal models and in vitro, the clinical significance has not been clearly evaluated [39][40][41][42][43]. Although there is demonstration of the toxicity of povidone-iodine in animal models and in vitro, the clinical significance has not been clearly evaluated [39][40][41][42][43].…”

Ozone Therapy: Overview of its Potential Utility in Male Reproduction

“…In autohemotherapy, small amount of blood is collected from the patient, then exposed ex vivo to ozone then infused back into the patient (Smith et al, 2017). Because ozone is a potent oxidant and a highly reactive molecule, it has strong bactericidal, antiviral, anti-fungal and antiprotozoalactions (Duricic et al, 2015;Yamayoshi and Tatsumi, 1993;Sugita et al, 1992;Sato et al, 1990) as well as other therapeutic effects (Duricic et al, 2015;Yamayoshi and Tatsumi, 1993;Sugita et al, 1992;Sato et al, 1990;Clavo et al, 2018;Kashiwagi et al, 2001). Due to the advantage of its multifaceted route of administration, ozone has been used to treat several pathologies such as cancers (Clavo et al, 2018;Dogan et al, 2018), bad abscesses (Karatieieva et al, 2017;Li et al, 2018) and chronic wounds (Fitzpatrick et al, 2018), skin diseases[such as acne (Gloor and Lipphardt, 1976), eczema (Kosheleva and Kulikov, 2001) and psoriasis (Evstigneeva et al, 2018), HIV infection (Garber et al, 1991;Carpendale et al, 1993;Frankum and Katelaris, 1993;OPOI, 1994), fibromyalgia (Hidalgo-Tallon et al, 2013), asthma (Turner et al, 1989), inflammatory conditions (Kucukgul et al, 2016) including arthritis (Raeissadat et al, 2018;Manoto et al, 2018), cardiac conditions (Buyuklu et al, 2017), liver disorders (Safwat et al, 2014;Tezcan et al, 2018), eye disorders (Kaya et al, 2017), urinary tract pathologies (Tasdemir et al, 2013), dyslipidemia…”

Povidone-iodine application induces corneal cell death through fixation

“…In ophthalmology, PI can induce cytotoxicity at concentrations ranging from 5% to 10% in vivo and 0.08% to 0.32% in vitro 8 9. Washing rabbit eyes with 1.25% PI results in superficial punctate keratitis 10. Multiple applications of 0.5% PI in rabbit eye models delays corneal epithelial healing,11 whereas injection of PI into the anterior chamber causes corneal endothelial toxicity12 and corneal oedema 13.…”

“…Multiple applications of 0.5% PI in rabbit eye models delays corneal epithelial healing,11 whereas injection of PI into the anterior chamber causes corneal endothelial toxicity12 and corneal oedema 13. Based on in vitro studies, PI can kill corneal endothelial cells (at 0.1%),13 corneal fibroblasts (at 0.25%)14 and corneal epithelial cells (at 0.0125%),15 and reduces corneal epithelium barrier function (at 1.25%, 10 min) 10. However, whether PI induces cell death through necrosis, apoptosis or fixation remains less well understood.…”