Intraocular Povidone Iodine During Pars Plana Vitrectomy for Severe and Atypical Endophthalmitis

BACKGROUND AND OBJECTIVE: To describe the experience and clinical outcomes of povidone iodine (PI) infusion in the setting of pars plana vitrectomy for the treatment of endophthalmitis. MATERIALS AND METHODS: This was a retrospective case series of 12 patients with clinical and/or culture evidence of endophthalmitis requiring pars plana vitrectomy with 0.025% PI used in vitreous irrigation solution during vitrectomy. The primary endpoint was clinical resolution of the infection. Secondary endpoints included visual recovery, need for repeat surgery, and ocular toxicity RESULTS: There were 11 eyes that showed clinical or culture evidence of resolution of infection postoperatively (91.7%); 10 eyes had improvement in vision postoperatively (83.3%). Overall uncorrected visual acuity improved from 20/5321 (2.43 ± 0.58 logMAR) to 20/375 (1.27 ± 1.05 logMAR) ( P = .0003). No clinical evidence of ocular toxicity or unexplained vision loss due to PI was observed. CONCLUSIONS: PI infusion during pars plana vitrectomy for endophthalmitis appears safe and led to excellent post-surgical results in a traditionally high-risk cohort. [ Ophthalmic Surg Lasers Imaging Retina. 2021;52:485–490.]