FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Veterinary ophthalmology2024; doi: 10.1111/vop.13306

Efficacy of 0.2% povidone-iodine and 0.1% polyhexamethylene biguanide as preoperative antiseptics in equine ophthalmic procedures.

Abstract: This retrospective study evaluates the efficacy of povidone-iodine (PI) and polyhexamethylene biguanide (PHMB) as preoperative antiseptics in equine ophthalmic procedures. Methods: Horses that underwent routine ophthalmic surgery and procedures. Methods: Data were collected retrospectively from the medical records of equine patients undergoing ophthalmic procedures. Inclusion criteria were sampling for aerobic microbial culture at three different time points (T0: pre-irrigation, T1: post-irrigation, and T2: postoperatively) and T0 showing bacterial growth. Microbiological outcomes were assessed semi-quantitatively by creating a scoring system to describe the bacterial load. Furthermore, the species detected were evaluated. Poisson regression analysis was performed to evaluate the efficacy of the disinfectants. Results: Eighty eyes (75 horses) met the inclusion criteria, with 36 cases being aseptically prepared with PI and 44 with PHMB. Both antiseptics significantly reduced the bacterial load and number of bacterial species (p < .001) between time points T0 and T1, and T0 and T2. PHMB showed a reduction in the bacterial load by 64% (CI: 51%-73%) whereas PI reduced it by 48% (CI: 36%-58%) between time points T0 and T1. The reduction in the number of bacterial species between time points T0 to T1 was significantly greater in the PHMB group (85%, CI: 70%-93%), compared to PI (47%, CI: 26%-62%). Conclusions: Both PHMB and PI reduced the bacterial load and number of species on the ocular surface and eyelids significantly, with 0.1% PHMB being superior to 0.2% PI. Therefore, PHMB can be considered as a good alternative in preoperative antisepsis in equine ophthalmic procedures.
© 2024 The Author(s). Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists.
Get Full Text
Publication Date: 2024-12-08 PubMed ID: 39648293DOI: 10.1111/vop.13306Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study assesses the effectiveness of povidone-iodine and polyhexamethylene biguanide as disinfectants used before eye surgeries in horses. It concludes that both significantly reduce bacteria on the eye surface, with polyhexamethylene biguanide proving more successful.

Study Design and Methodology

A retrospective study design was used for the research, focusing on horses that underwent routine eye surgeries. Some key insights on the methodology include:

  • This study’s data was gathered from historical medical records of horses that had undergone surgical eye procedures.
  • Only cases where bacterial culture samples were taken at three distinct phases (pre-irrigation, post-irrigation, and post-surgery) and initial samples exhibited bacteria growth were considered for the study.
  • The bacterial load was semi-quantitatively assessed by developing a scoring system.
  • The types of bacteria detected were also examined in the study.
  • A statistical method known as Poisson regression analysis was employed to judge the effectiveness of the disinfectants.

Findings

Reach into 80 eyes (from 75 horses) met the study’s criteria. Some used povidone-iodine as the preoperative antiseptic, while others used polyhexamethylene biguanide. The findings include:

  • Both disinfectants led to a significant decrease in bacterial load and variation at the following periods: pre- and post-irrigation, and pre-irrigation and post-surgery.
  • Polyhexamethylene biguanide resulted in a 64% reduction in bacterial load between the pre- and post-irrigation stages, while povidone-iodine achieved a 48% reduction for the same phases.
  • The drop in bacterial species between the pre-irrigation and post-irrigation stages was notably larger in the group treated with polyhexamethylene biguanide compared to the povidone-iodine group.

Conclusion

The study concludes:

  • Both polyhexamethylene biguanide and povidone-iodine significantly lowered the bacterial count and species diversity on the ocular surface and eyelids.
  • In comparison to povidone-iodine, polyhexamethylene biguanide was more effective in reducing bacterial load and diversity, rendering it a preferable choice for preoperative antisepsis in eye surgeries on horses.

Cite This Article

APA
Farkas A, Thieme K, Soimala T, Jensen CK, Eule JC. (2024). Efficacy of 0.2% povidone-iodine and 0.1% polyhexamethylene biguanide as preoperative antiseptics in equine ophthalmic procedures. Vet Ophthalmol. https://doi.org/10.1111/vop.13306

Publication

Veterinary ophthalmology
ISSN: 1463-5224
NlmUniqueID: 100887377
Country: England
Language: English

Researcher Affiliations

Farkas, Anna
  • Unit for Ophthalmology, Veterinary Hospital Freie Universität Berlin, Berlin, Germany.
Thieme, Katharina
  • Unit for Ophthalmology, Veterinary Hospital Freie Universität Berlin, Berlin, Germany.
Soimala, Tanawan
  • Unit for Ophthalmology, Veterinary Hospital Freie Universität Berlin, Berlin, Germany.
Jensen, Charlotte K
  • Institute of Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany.
Eule, J Corinna
  • Unit for Ophthalmology, Veterinary Hospital Freie Universität Berlin, Berlin, Germany.

References

This article includes 57 references
  1. Gould D, Dewhurst E, Papasouliotis K. Clinical microbiology and parasitology. In: Gelatt KN, ed. Veterinary Ophthalmology. Sixth Edition ed. John Wiley & Sons, Inc; 2021:293‐384.
  2. Zaharia A‐C, Dumitrescu O‐M, Rogoz R‐E, Dimirache AE, Zemba M. Preoperative antisepsis in ophthalmic surgery (a review). Rom J Ophthalmol 2021;65:120‐124.
  3. Carrim ZI, Mackie G, Gallacher G, Wykes WN. The efficacy of 5% povidone‐iodine for 3 minutes prior to cataract surgery. Eur J Ophthalmol 2009;19:560‐564.
  4. Borgia A, Mazzuca D, Della Corte M. Prophylaxis of ocular infection in the setting of intraocular surgery: implications for clinical practice and risk management. Ophthalmol Therapy 2023;12:721‐734.
  5. Tognetto D, Pastore MR, Guerin GM. Bactericidal activity of three different antiseptic ophthalmic preparations as surgical prophylaxis. Graefes Arch Clin Exp Ophthalmol 2022;260:289‐293.
  6. Kanclerz P, Myers WG. Potential substitutes for povidone‐iodine in ocular surgery. Eye 2021;35:2657‐2659.
  7. Kunisada T, Yamada K, Oda S, Hara O. Investigation on the efficacy of povidone‐iodine against antiseptic‐resistant species. Dermatology 1997;195:14‐18.
  8. Yasuda T, Yoshimura Y, Takada H. Comparison of bactericidal effects of commonly used antiseptics against pathogens causing nosocomial infections. Dermatology 1997;195:19‐28.
  9. Hoekstra MJ, Westgate SJ, Mueller S. Povidone‐iodine ointment demonstrates in vitro efficacy against biofilm formation. Int Wound J 2017;14:172‐179.
  10. Oduwole KO, Glynn AA, Molony DC. Anti‐biofilm activity of sub‐inhibitory povidone‐iodine concentrations against Staphylococcus epidermidis and Staphylococcus aureus. J Orthop Res 2010;28:1252‐1256.
  11. Johani K, Malone M, Jensen SO. Evaluation of short exposure times of antimicrobial wound solutions against microbial biofilms: from in vitro to in vivo. J Antimicrob Chemother 2018;73:494‐502.
  12. Capriotti JP, Pelletier J, Barone S, Capriotti J. Efficacy of dilute povidone‐iodine against multi‐ drug resistant bacterial biofilms, fungal biofilms and fungal spores. J Clin Res Dermatol 2018;5:1‐5.
  13. Kawana R, Kitamura T, Nakagomi O. Inactivation of human viruses by povidone‐iodine in comparison with other antiseptics. Dermatology 1997;195:29‐35.
  14. Wutzler P, Sauerbrei A, Klöcking R, Brögmann B, Reimer K. Virucidal activity and cytotoxicity of the liposomal formulation of povidone‐iodine. Antivir Res 2002;54:89‐97.
  15. Tan EL, Johari NH. Comparative in vitro evaluation of the antimicrobial activities of povidone‐iodine and other commercially available antiseptics against clinically relevant pathogens. GMS Hyg Infect Control 2021;16:Doc05.
  16. Tortorano AM, Viviani MA, Biraghi E, Rigoni AL, Prigitano A, Grillot R. In vitro testing of fungicidal activity of biocides against aspergillus fumigatus. J Med Microbiol 2005;54:955‐957.
  17. Lachapelle JM, Castel O, Casado AF. Antiseptics in the era of bacterial resistance: a focus on povidone iodine. Clin Pract 2013;10:579‐592.
  18. Kida N. Bactericidal and sporicidal activities of an improved iodide formulation and its derivative. Biocontrol Sci 2009;14:113‐118.
  19. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147‐179.
  20. Berkelman RL, Holland B, Anderson R. Increased bactericidal activity of dilute preparations of povidone‐iodine solutions. J Clin Microbiol 1982;15:635‐639.
  21. Grzybowski A, Kanclerz P, Myers WG. The use of povidone–iodine in ophthalmology. Curr Opin Ophthalmol 2018;29:19‐32.
  22. Williams J, Lane S, Harniman S. An in vitro investigation into the efficacies of chlorhexidine gluconate, povidone iodine and green tea (Camellia sinensis) to prevent surgical site infection in animals. Vet Nurse 2016;7:485‐492.
  23. Frank S, Brown SM, Capriotti JA, Westover JB, Pelletier JS, Tessema B. In vitro efficacy of a povidone‐iodine nasal antiseptic for rapid inactivation of SARS‐CoV‐2. JAMA Otolaryngol 2020;146:1054.
  24. Elzein R, Abdel‐Sater F, Fakhreddine S. In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone‐iodine mouthwashes against salivary SARS‐CoV‐2. A randomized‐controlled clinical trial. J Evid Based Dent Pract 2021;21:101584.
  25. Jiang J, Wu M, Shen T. The toxic effect of different concentrations of povidone iodine on the rabbit's cornea. Cutan Ocul Toxicol 2009;28:119‐124.
  26. Naor J, Savion N, Blumenthal M, Assia EI. Corneal endothelial cytotoxicity of diluted povidone–iodine. J Cataract Refract Surg 2001;27:941‐947.
  27. Roberts SM, Severin GA, Lavach JD. Antibacterial activity of dilute povidone‐iodine solutions used for ocular surface disinfection in dogs. Am J Vet Res 1986;47:1207‐1210.
  28. Allgoewer I. Principles of ophthalmic surgery. In: Maggs DJ, Miller PE, Ofri R, eds. Slatter's Fundamentals of Veterinary Ophthalmology. Sixth ed. Elsevier; 2018:89‐100.
  29. Wilkie DA. Fundamentals of ophthalmic microsurgery. In: Gelatt KN, ed. Veterinary Ophthalmology. Sixth Edition ed. John Wiley & Sons, Inc; 2021:787‐814.
  30. Chindera K, Mahato M, Kumar Sharma A. The antimicrobial polymer PHMB enters cells and selectively condenses bacterial chromosomes. Sci Rep 2016;6:23121.
  31. Feng L, Wu F, Li J, Jiang Y, Duan X. Antifungal activities of polyhexamethylene biguanide and polyhexamethylene guanide against the citrus sour rot pathogen Geotrichum citri‐aurantii in vitro and in vivo. Postharvest Biol Technol 2011;61:160‐164.
  32. Kollmuss M, Tolksdorf K, Würsching S, Hickel R, Huth K. Effect of polyhexanide as antiseptic mouth rinse against oral pathogens in an in vitro biofilm model. Acta Odontol Scand 2021;79:1‐8.
  33. Von Ohle C. PR092: antiviral activity of polyhexanide containing mouthrinses on periodontal and saliva‐associated biofilms. J Clin Periodontol 2018;45:150‐151.
  34. Pinto F. Mechanisms of action of polyhexamethylene biguanide‐based biocides against non‐enveloped virus. 2010.
  35. Duguid IGM, Dart JKG, Morlet N. Outcome of acanthamoeba keratitis treated with polyhexamethyl biguanide and propamidine. Ophthalmology 1997;104:1587‐1592.
  36. Asero A, Salvador M, Venturella S, Oberto G, Blanco AR. Safety of polyhexanide (PHMB) 0.08% ophthalmic solution after 26‐week repeated‐dose ocular administration in rabbits. Invest Ophthalmol Vis Sci 2017;58:5171.
  37. Patel NV, Mathur U, Sawant S, Acharya M, Gandhi A. Three consecutive cases of ocular polyhexamethylene biguanide (PHMB) toxicity due to compounding error. Cureus 2023;15:e38540.
  38. Hansmann F, Kramer A, Ohgke H, Strobel H‐G, Müller M, Geerling G. Polyhexamethylbiguanid (PHMB) as preoperative antiseptic for cataract surgery. Ophthalmologe 2004;101:377‐383.
  39. Mendivil Soto A, Mendivil MP. The effect of topical povidone‐iodine, intraocular vancomycin, or both on aqueous humor cultures at the time of cataract surgery. Am J Ophthalmol 2001;131:293‐300.
  40. Walters RF, Boase DL, Cockcroft PM. Povidone‐iodine and the prevention of bacterial contamination of the eye during extracapsular cataract surgery. Eur J Impl Refract Surg 1993;5:242‐246.
  41. Ferguson AW. Comparison of 5% povidone‐iodine solution against 1% povidone‐iodine solution in preoperative cataract surgery antisepsis: a prospective randomised double blind study. Br J Ophthalmol 2003;87:163‐167.
  42. Koerner JC, George MJ, Meyer DR, Rosco MG, Habib MM. Povidone‐iodine concentration and dosing in cataract surgery. Surv Ophthalmol 2018;63:862‐868.
  43. York KK, Miller S, Gaster RN, Burstein NL. Polyvinylpyrrolidone iodine: corneal toxicology and epithelial healing in a rabbit model. J Ocul Pharmacol 1988;4:351‐358.
  44. Saedon H, Nosek J, Phillips J, Narendran N, Yang YC. Ocular surface effects of repeated application of povidone iodine in patients receiving frequent intravitreal injections. Cutan Ocul Toxicol 2017;36:343‐346.
  45. ElKitkat RS, Ebeid WM, Habib EK, Shoukry Y. Safety of intracameral injection of minimal bactericidal concentration of povidone iodine on the corneal endothelium in a rabbit model. Cornea 2016;35:72‐76.
  46. Shimada H, Kato K, Ishida K, Yamaguchi T, Shinoda K. Evaluation of retinal function and pathology after intravitreal injection of povidone‐iodine and polyvinyl alcohol‐iodine in rabbits. Transl Vis Sci Technol 2020;9:5.
  47. Coyne K, Papagiannis IG. Severe thyrotoxicosis following topical iodine application. J Endocrin Soc 2021;5:A953‐A954.
  48. Stades FC, Wyman M, Boevé M, Neumann W, Spiess DBM. Ophthalmology for the Veterinary Practitioner. Schlütersche; 2007.
  49. Caruso C, Eletto D, Tosco A. Comparative evaluation of antimicrobial, antiamoebic, and antiviral efficacy of ophthalmic formulations. Microorganisms 2022;10:1156.
  50. Budzinskaya MV. Ocular flora in patients undergoing intravitreal injections: antibiotic resistance patterns and susceptibility to antiseptic picloxydine. Int J Ophthalmol 2020;13:85‐92.
  51. Spadea L, Zanotto E, Cavallo R, Campagna G, Giannico MI, Costagliola C. Effectiveness of liposomal ozonized oil in reducing ocular microbial flora in patients undergoing cataract surgery. J Cataract Refract Surg 2021;47:1548‐1555.
  52. Huppes T, Hermans H, Ensink JM. A retrospective analysis of the risk factors for surgical site infections and long‐term follow‐up after transpalpebral enucleation in horses. BMC Vet Res 2017;13:155.
  53. Van Der Lelij A, Rothova A. Diagnostic anterior chamber paracentesis in uveitis: a safe procedure?. Br J Ophthalmol 1997;81:976‐979.
  54. Helbig H, Noske W, Kleineidam M, Kellner U, Foerster MH. Bacterial endophthalmitis after anterior chamber paracentesis. Br J Ophthalmol 1995;79:866.
  55. Merani R, Hunyor AP. Endophthalmitis following intravitreal anti‐vascular endothelial growth factor (VEGF) injection: a comprehensive review. Int J Retina Vitreous 2015;1:9.
  56. Fileta JB, Scott IU, Flynn HW Jr. Meta‐analysis of infectious endophthalmitis after intravitreal injection of anti‐vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina 2014;45:143‐149.
  57. Lafrentz S, Abarca E, Mohammed HH, Cuming R, Arias CR. Characterization of the normal equine conjunctival bacterial community using culture‐independent methods. Vet Ophthalmol 2020;23:480‐488.

Citations

This article has been cited 2 times.
  1. Stolle LM, Oltmanns H, Meißner J, Heun F, Schieder AK, Wolff HT, Ohnesorge B, Busse C. Polyhexanide, Povidone-Iodine, and Hypochlorous Acid Show High In Vitro Antimicrobial Efficacy Against Pathogens Commonly Associated With Equine Infectious Keratitis. Vet Ophthalmol 2026 Jan;29(1):e70141.
    doi: 10.1111/vop.70141pubmed: 41552904google scholar: lookup
  2. Kirmse L, Thieme K, Doherr MG, Eule JC. Evaluation of Laboratory Techniques for the Diagnosis of Leptospira-Associated Equine Recurrent Uveitis (ERU) With Focus on the Goldmann-Witmer Coefficient. Vet Ophthalmol 2026 Jan;29(1):e70132.
    doi: 10.1111/vop.70132pubmed: 41518147google scholar: lookup
Subscribe to our newsletter
Join 99,850 horse owners like you who receive our email updates on horse health and nutrition.