Pars Plana Vitrectomy Using 0.025% Povidone-Iodine Irrigation for Acute Endophthalmitis: A Retrospective Case-Control Study
Abstract
Purpose To compare visual and anatomical outcomes of patients with acute endophthalmitis treated with pars plana vitrectomy (PPV) using either 0.025% povidone-iodine (PI) or standard balanced salt solution (BSS) irrigation and to evaluate the safety profile of intraocular PI. Design Retrospective case-control study. Subjects Ninety-two patients (48 in the PI group and 44 in the BSS group) aged ≥18 years with acute endophthalmitis of various etiologies treated between January 2017 and December 2024. Methods All patients underwent 23- or 25-gauge PPV and received intravitreal moxifloxacin and dexamethasone. The study group received 0.025% PI irrigation, whereas the control group received standard BSS irrigation. Main outcomes included best-corrected visual acuity (BCVA), infection resolution, reactivation, and postoperative findings potentially associated with ocular toxicity. Safety assessments were based on slit-lamp examination, retinal imaging, and optical coherence tomography. Results Clinical resolution at 1 week was achieved in 68.8% of eyes in the PI group and 65.9% in the control group (p = 0.83). No statistically significant differences were observed between groups regarding infection resolution, recurrence/reactivation, or BCVA outcomes. At 3 months, mean BCVA was logMAR 1.096 (approximately 20/250) in the PI group and logMAR 1.70 (count fingers) in the control group. Fewer postoperative findings potentially associated with ocular toxicity were observed in the PI…
How strong is the evidence?
Evidence Hub reads this as a case-control. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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