We surveyed 572 surgeons, of whom 386 (67%) responded. Most of the surgeons (94%) used
iodine compounds before surgery for periocular skin disinfection (
povidone-iodine [PI]: 79%;
polyvinyl alcohol-
iodine [PAI]: 15%) or conjunctival disinfection (85%; PI: 36%; PAI: 49%). Preoperative conjunctival
iodine was primarily used as an eye wash (irrigation: 95%) and less often as an
eye drop (5%). It was determined that 31% of surgeons waited 30 seconds or more between periocular disinfection and conjunctival disinfection. During surgery, 14% of surgeons used
iodine several times, including immediately before
intraocular lens insertion, and 7% used the Shimada technique (repeated
iodine irrigation). Preoperative
antibiotic eye drops were used by 99% of surgeons, and
antibiotics were added to the irrigation bottle by 22%. The surgeons reported use of subconjunctival
antibiotic injections (23%),
antibiotic ointments (79%), and intracameral
antibiotics (7%: 22
moxifloxacin; 6
levofloxacin). All surgeons prescribed postoperative
eye drops, with 10% initiating the drops on the day of surgery.
CONCLUSION:
Iodine compounds are commonly used preoperatively, but few institutions use
iodine compounds intraoperatively, particularly with repeated application. The selection of
antibiotic administration and disinfection technique has to be at the surgeon's discretion. However, intracameral
antibiotic and intraoperative
iodine compound use are techniques that should be widely recognized.