Clinical Outcomes of Intravitreal 0.625% Povidone-Iodine Injection for Endophthalmitis Treatment

Purpose: We evaluated the treatment outcomes of intravitreal 0.625% povidone-iodine (PI) injection in patients with exogenous and endogenous endophthalmitis.Methods: We retrospectively analyzed the medical records of 21 patients (23 eyes) who received intravitreal 0.625% PI injections for endophthalmitis between March 2021 and December 2023.Results: Of the 21 patients, 19 (19 eyes) had exogenous endophthalmitis, with the most common etiology being post-cataract surgery endophthalmitis in 14 eyes (58.3%). The mean number of intravitreal PI injections administered was 1.6 ± 0.7. The mean time to hypopyon resolution was 2.5 ± 2.1 days. Pars plana vitrectomy (PPV) was required in 16 eyes (84.2%), with an average of 1.1 ± 0.5 surgical interventions. The best-corrected visual acuity (BCVA, logMAR) improved significantly from 2.06 ± 0.52 before treatment to 1.00 ± 0.96 after treatment (p < 0.001). Four eyes of two patients with endogenous endophthalmitis received a mean of 2.5 ± 1.0 intravitreal PI injections (range: 2-4). Clinical improvement was observed in all cases.Conclusions: Intravitreal 0.625% PI injection appears to be a potentially effective alternative to conventional antibiotic therapy for the treatment of endophthalmitis.