A randomised trial of povidone-iodine to reduce visual impairment from corneal ulcers in rural Nepal

Joanne Katz, S. K. Khatry, M. D. Thapa, O. D. Schein, E. Kimbrough Pradhan, S. C. LeClerq, K. P. West

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To assess whether povidone-iodine provided any benefit over and above a standard regimen of antibiotic therapy for the treatment of corneal ulcers. Methods: All patients diagnosed with corneal ulcers presenting for care at a primary eye care clinic in rural Nepal were randomised to a standard protocol of antibiotic therapy versus standard therapy plus 2.5% povidone-iodine every 2 hours for 2 weeks. The main outcomes were corrected visual acuity and presence, size, and position of corneal scarring in the affected eye at 2-4 months following treatment initiation. Results: 358 patients were randomised and 81% were examined at follow up. The two groups were comparable before treatment. At follow up, 3.9% in the standard therapy and 6.9% in the povidone-iodine group had corrected visual acuity worse than 20/400 (relative risk (RR) 1.77, 95% confidence interval (CI) 0.62 to 5.03). 9.4% in the standard therapy and 13.1% in the povidone-iodine group had corrected visual acuity worse than 20/60 (RR 1.39, 95% CI 0.71 to 2.77), and 17.0% and 18.8% had scars in the visual axis in each of these groups, respectively (RR 1.11, 95% CI 0.67 to 1.82). Conclusions: A small proportion of patients with corneal ulceration treated in this setting had poor visual outcomes. The addition of povidone-iodine to standard antibiotic therapy did not improve visual outcomes, although this design was unable to assess whether povidone-iodine on its own would have resulted in comparable visual outcomes to that of standard therapy.

Original languageEnglish (US)
Pages (from-to)1487-1492
Number of pages6
JournalBritish Journal of Ophthalmology
Volume88
Issue number12
DOIs
StatePublished - Dec 2004

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Fingerprint Dive into the research topics of 'A randomised trial of povidone-iodine to reduce visual impairment from corneal ulcers in rural Nepal'. Together they form a unique fingerprint.

Cite this