重视聚维酮碘在白内障手术中的应用与研究  

Pay attention to the application and research of povidone iodine in cataract surgery

作　　者：赵天瑶 孙英娟 江晓丹[3] 李学民[3] Zhao Tianyao;Sun Yingjuan;Jiang Xiaodan;Li Xuemin(Doctoral degree 2021,Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China;Fangshan Hospital Beijing University of Chinese Medicine,Beijing 102400,China;Department of Ophthalmology,Peking University Third Hospital,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve,Beijing 100191,China)

机构地区：[1]北京大学第三医院眼科中心,100191 [2]北京中医药大学房山医院眼科,102400 [3]北京大学第三医院眼科中心、眼部神经损伤的重建保护与康复北京市重点实验室,100191

出　　处：《中华眼科医学杂志（电子版）》2024年第2期65-70,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：首都卫生发展科研专项项目(首发2024-2-40913)。

摘　　要：聚维酮碘(PVI)作为白内障术前消毒的常规选择,因其高效广谱的抗菌特性而广泛应用于眼科手术中。PVI通过氧化作用和直接损伤微生物细胞结构发挥抗菌效果,对多种细菌、真菌及病毒具有杀灭作用,但PVI在眼内具有潜在毒性,需要关注其药物浓度、时间选择及患者耐受性等问题。既往的研究结果表明,适当浓度和作用时间的PVI对角膜上皮和角膜内皮细胞损伤较小,但高浓度PVI可能对眼部组织产生不良影响。此外,PVI在前房内的药代动力学特性对于评估其预防术后眼内炎效果至关重要,但相关机制尚不完全明确。未来的研究将聚焦于优化PVI的使用浓度和剂量、开发新配方、探索替代或联合使用的抗菌剂,并更新临床实践指南以提升PVI使用的安全性和有效性。本文中笔者对PVI的抗菌特性、在白内障术前消毒中的应用规范、不同浓度PVI的应用效果、潜在毒性及未来研究的方向进行评述。Povidone-iodine(PVI),as a conventional choice for preoperative disinfection in cataract surgery,has been extensively utilized in ophthalmic procedures due to its efficient and broad-spectrum antimicrobial properties.PVI exerts antibacterial effects through oxidation and direct damage to microbial cell structures,and has a killing effect on various bacteria,fungi,and viruses.However,PVI has a potential toxicity for the eyes.Its drug concentration,time selection,and patient tolerance should be paid attention.It has shown that PVI with appropriate concentration and duration of action causes less damage to corneal epithelium and endothelial cells,but high concentrations of PVI may have adverse effects on ocular tissues.Moreover,the pharmacokinetic characteristics of PVI within the anterior chamber are crucial for evaluating its effectiveness in preventing postoperative endophthalmitis,yet the relevant mechanisms are not fully understood.Future research will focus on optimizing the concentration and dosage of PVI,developing new formulations,exploring alternative or combination antimicrobial agents,and updating clinical practice guidelines to enhance the safety and efficacy of PVI use.The antibacterial properties of PVI,the application standards in preoperative disinfection of cataracts,the application effects of different concentrations of PVI,potential toxicity,and future research directions were reviewed in this paper.

关 键 词：聚维酮碘 白内障手术 术前消毒 药代动力学 眼部毒性 

分 类 号：R779.66[医药卫生—眼科]