聚维酮碘在白内障手术中的应用进展

Application progress of povidone-iodine in cataract surgery

20世纪80年代,聚维酮碘(PVP-I)开始应用于眼表和眼周皮肤的消毒来预防白内障手术后的眼内炎。PVP-I的非选择性作用机制不会使细菌产生耐药性,较抗生素和其他消毒剂有多种优势,是目前临床上最接近理想的杀菌剂。白内障术前应用PVP-I结膜囊冲洗已成为全球共识,但目前国内外对PVP-I的浓度和作用时间尚没有统一的要求和标准。PVP-I对眼表有毒性作用,呈浓度和时间依赖性,所以权衡功效和毒性至关重要,关系到患者手术的预后和恢复。应用高浓度或是低浓度的PVP-I冲洗结膜囊仍存在争议,需进一步研究及探讨。

Povidone-Iodine(PVP-I)has been used to disinfect the ocular surface and periocular skin to prevent endophthalmitis after cataract surgery since the 1980s.The non-selective mechanism of action of PVP-I does not cause bacteria to develop resistance and has several advantages over antibiotics and other disinfectants,making it the closest to the ideal disinfectant in clinical practice.There is a global consensus on the use of PVP-I conjunctival sac irrigation before cataract surgery,but there are no uniform requirements or standards for the concentration and duration of action of PVP-I at home and abroad.PVP-I has toxic effects on the ocular surface in a time-and concentration-dependent manner,so the balance between efficacy and toxicity is critical to the patient's prognosis and recovery from surgery.The use of high or low concentrations of PVP-I for irrigation of conjunctival sac is still controversial,which requires further discussion and research.