Razavi Behzad, Zollinger Richard, Kramer Axel, Fricke Cordula, Völzke Henry, Jäger Bernd, Spielhagen Christin, Behrens-Baumann Wolfgang, Below Harald
Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ernst-Moritz-Arndt University, Germany.
Cutan Ocul Toxicol. 2013 Oct;32(4):279-82. doi: 10.3109/15569527.2013.776574. Epub 2013 Mar 26.
Polyvinylpyrrolidone-Iodine (PVP-I) is routinely used as preoperative antiseptic during ophthalmic surgery. Iodine absorption from iodine-containing antiseptics can lead to the development of thyroid disorders. Therefore, a quantitative measurement of iodine absorption from these antiseptics was performed in patients undergoing elective cataract surgery.
This study enrolled 241 patients to evaluate systemic iodine absorption after exposure to conjunctival and/or periorbital 1.25% and 10% PVP-I compared to an iodine-free antiseptic.
All patients who received the 10% PVP-I regardless of the application site showed a 1.2-1.5-fold increase in urinary iodine excretion after 24 h (p = 0.01). In 17 out of 110 (15.5%) patients in whom 10% PVP-I was used, the critical threshold of urinary iodine excretion as defined by WHO (>300 µg/L) was exceeded. In contrast, no significant ioduria was observed with the use of 1.25% PVP-I except in patients after 48 h (p = 0.01) and with a concurrent conjunctival and periorbital application. The proportion of the excreted iodine in urine ranged from 0.24% to 1.77%. No correlation was found between the total applied concentration of iodine and the amount excreted in urine.
Based on our findings, we believe that the use of 10% PVP-I as preoperative ophthalmic antiseptic should undergo further clinical evaluation in regard to its impact on thyroid function. Conjunctival or periorbital application of 1.25% PVP-I does not result in significant ioduria.
聚乙烯吡咯烷酮碘（PVP-I）在眼科手术中常被用作术前防腐剂。含碘防腐剂中的碘吸收可能导致甲状腺疾病的发生。因此，对接受择期白内障手术的患者进行了这些防腐剂碘吸收的定量测量。
本研究纳入241例患者，以评估与不含碘的防腐剂相比，接触结膜和/或眶周1.25%和10% PVP-I后全身碘吸收情况。
所有接受10% PVP-I的患者，无论应用部位如何，24小时后尿碘排泄量均增加1.2 - 1.5倍（p = 0.01）。在使用10% PVP-I的110例患者中的17例（15.5%）中，尿碘排泄量超过了世界卫生组织定义的临界阈值（>300 μg/L）。相比之下，使用1.25% PVP-I时，除48小时后的患者（p = 0.01）以及结膜和眶周同时应用的情况外，未观察到明显的碘尿。尿中排泄碘的比例为0.24%至1.77%。未发现碘的总应用浓度与尿中排泄量之间存在相关性。
基于我们的研究结果，我们认为10% PVP-I作为术前眼科防腐剂对甲状腺功能的影响应进行进一步的临床评估。结膜或眶周应用1.25% PVP-I不会导致明显的碘尿。
