表面灌洗 0.25%聚维酮碘降低 25G 玻切术后玻璃体污染率。
Reduction of vitreous contamination rate after 25-gauge vitrectomy by surface irrigation with 0.25% povidone-iodine.
机构信息
Department of Ophthalmology, School of Medicine, Nihon University, Chiyodaku, Tokyo, Japan.
出版信息
Retina. 2013 Jan;33(1):143-51. doi: 10.1097/IAE.0b013e318261a6ce.
PURPOSE
To examine whether repeated ocular surface irrigation with 0.25% povidone-iodine, which is highly bactericidal and nonoculotoxic, reduces bacterial contamination of the vitreous during 25-gauge vitrectomy.
METHODS
Overall, 4,407 eyes undergoing 25-gauge vitrectomy were studied; of these, 2,801 were irrigated with infusion fluid (group A) and 1,606 with 0.25% povidone-iodine (group B). In each group (A and B), 103 eyes were studied bacteriologically, using ocular surface fluid samples after placing lid speculum (S1), after operative field irrigation (S2), and in vitreous samples at the beginning (V1) and at the completion of vitrectomy (V2).
RESULTS
Bacterial contamination rate in S1 did not differ significantly between the groups A (5.5%) and B (6.8%). However, the contamination rates in S2, V1, and V2 were apparently lower in group B (0%, 0%, and 0%, respectively) than in group A (2.0%, 1.0%, and 2.0%, respectively). Incidence of endophthalmitis was 0 of 2,801 eyes in group A and 0 of 1,606 eyes in group B.
CONCLUSION
In 25-gauge vitrectomy, repeated operative field irrigation with 0.25% povidone-iodine reduced bacterial contamination in vitreous to extremely low level.
目的
研究 0.25%聚维酮碘（高度杀菌且对眼无毒性）对眼表重复冲洗能否降低 25G 玻璃体切割术中玻璃体的细菌污染。
方法
共有 4407 只眼行 25G 玻璃体切割术，其中 2801 只眼用灌注液冲洗（A 组），1606 只眼用 0.25%聚维酮碘冲洗（B 组）。每组（A 组和 B 组）中各有 103 只眼行细菌学研究，分别在放置开睑器后（S1）、手术野冲洗后（S2）和玻璃体切割开始时（V1）及结束时（V2）取眼表液样本。
结果
A 组（5.5%）和 B 组（6.8%）的 S1 细菌污染率无显著差异。但 B 组的 S2、V1 和 V2 的污染率明显较低（分别为 0%、0%和 0%），A 组分别为 2.0%、1.0%和 2.0%。A 组 2801 只眼中无一例发生眼内炎，B 组 1606 只眼中也无一例发生眼内炎。
结论
在 25G 玻璃体切割术中，用 0.25%聚维酮碘对手术野重复冲洗可将玻璃体中的细菌污染降低至极低水平。
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