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September 2, 2026Retina

Adjunct 0.025% Povidone-Iodine Irrigation at Time of Vitrectomy for Management of Infectious Endophthalmitis: A Multicenter Single-Intervention Study

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Authors

MYMelissa YuanKPKeerti PallyBDBrian Do

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Overview

Comparative cohort study reveals improved visual outcomes with adjunctive povidone-iodine irrigation during vitrectomy for endophthalmitis, indicating a safe and cost-effective intervention.

Key Points

  • To determine whether adjunctive 0.025% povidone-iodine irrigation during pars plana vitrectomy improves visual acuity and reduces ocular morbidity in patients with infectious endophthalmitis compared to standard irrigation.
  • Multicenter, retrospective comparative cohort study conducted between 2019 and 2024 across four tertiary referral centers.
  • Evaluated 63 eyes from 63 patients with presumed infectious endophthalmitis receiving either adjunctive 0.025% povidone-iodine in balanced salt solution (n=32) or standard irrigation solution (n=31) during vitrectomy.
  • Assessed primary visual acuity outcomes at 3 and 6 months, alongside secondary endpoints of reoperation rates and adverse ocular events.
  • Median visual acuity was significantly better in the povidone-iodine group at 3 months (20/138 [0.84 logMAR] vs 20/3000 [2.21 logMAR], P=.017) and 6 months (20/60 [0.48 logMAR] vs 20/400 [1.34 logMAR], P=.010).
  • Vision improved in 96.7% (29/30) of povidone-iodine eyes versus 48.3% (14/29) of control eyes at 6 months (P<0.001), with clinically meaningful gains of ≥0.3 logMAR achieved in 80.0% (24/30) versus 41.4% (12/29; P=.003).
  • Reoperation rates were 28.1% (9/32) in the povidone-iodine group and 16.1% (5/31) in the control group (P=.365), with no observed ocular toxicity attributed to povidone-iodine.

Cite This Study

Yuan et al. (2026) studied this question.

synapsesocial.com/papers/6a97e2c5c562ede874ec710ahttps://doi.org/10.1097/iae.0000000000005006
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