Povidone-Iodine Adverse Effects and Alternatives for Ocular Procedures

Reporting serious incidents in medical devices used in intraocular surgery: Proposing ideas

The entry into force of the regulation on medical devices obliges clinicians to identify and report to the Health Authorities possible serious incidents arising from their use. In view of the doubts that may arise as to whether or not it may be considered a serious incident, a working group, set up by members of the Spanish Society of Retina and Vitreo and the cluster of ophthalmology and vision sciences (Cluster4Eye) have prepared a document that aims to guide ophthalmologists about some of the incidents that, in the experience of the work team, are not common or can cause serious damage to the patient's function.

In praise of povidone-iodine application in ophthalmology

Polyvinyl pyrrolidone or povidone-iodine (PVP-I) is a water-soluble complex formed by the combination of iodine and a water-soluble polymer, polyvinyl pyrrolidone. This complex exerts bactericidal, fungicidal, and virucidal action by gradually releasing free iodine at the site of application to react with pathogens. In ophthalmology, PVP-I is used as a disinfectant and antiseptic agent for preoperative preparation of the skin and mucous membranes and for treating contaminated wounds. PVP-I has been shown to reduce effectively the risk of endophthalmitis in various ocular procedures, including cataract surgery and intravitreal injections; however, it has also been used in the treatment of conjunctivitis, keratitis, and endophthalmitis, with promising results especially in low-resource situations. PVP-I has been associated with complications such as postoperative eye pain, persistent corneal epithelial defects, ocular inflammation, and an attendant risk of keratitis. In cases of poor PVP-I tolerance, applying PVP-I at lower concentrations or using alternative antiseptics such as chlorhexidine should be considered. We provide an update on the efficacy of PVP-I in the prophylaxis and treatment of conjunctivitis, keratitis, and endophthalmitis and a comprehensive analysis of the current literature regarding the use of PVP-I in the management of these ocular conditions. Also, PVP-I-related adverse effects and toxicities and its alternatives are discussed. The goal is to present a thorough evaluation of the available evidence and to offer practical recommendations for clinicians regarding the therapeutic usage of PVP-I in ophthalmology.

The effect of red fruit oil (Pandanus conoideus Lamk.) emulgel on angiogenesis and collagen density in incisive wound healing in mice (Mus musculus)

Pandanus conoideus Lamk. or commonly known as red fruit oil (RFO) can be used to accelerate wound healing because it contains tocopherols, carotenoids, oleic acid, linoleic acid, and linolenic acid. The RFO in this study was formulated in the form of an emulgel because it has the most convenient and effective drug delivery system. The aims of this study were to determine the activity of RFO emulgel on increasing the amount of angiogenesis and collagen density in incised wound healing and to determine the optimal dose of RFO emulgel to increase the amount of angiogenesis and collagen density in incised wound healing. This was a true experimental study with a posttest only control group design that included five treatment groups: a positive control group (10% povidone-iodine), a negative control (gel base), and three groups that varied the concentration of RFO emulgel used at 5%, 10%, and 15%. Parameters observed were the amount of angiogenesis using Image Raster software and the percentage of areas of collagen density using ImageJ software. The data were analyzed using a one-way ANOVA test and continued with the least significant difference test. The results of this study showed that RFO emulgel was able to increase the amount of angiogenesis and collagen density in the wound healing process with P = 0.000. An increase in the amount of angiogenesis and collagen density occurred in mice treated with RFO compared to the positive and negative control groups. It can be concluded that RFO emulgel has activity toward increasing the amount of angiogenesis and collagen density in the wound healing of mice incisions. The optimal dose concentration of RFO emulgel for increasing the amount of angiogenesis and collagen density in incision wound healing was shown in RFO emulgel with a concentration of 15%.