Corneal endothelial changes from exposure to povidone iodine solution.

Povidone iodine (PI) is a common preoperative antiseptic for eyelid and conjunctival preparation. The corneal endothelium may theoretically be exposed to PI during intraocular surgery or during the repair of a corneal laceration. This study explores the changes in corneal endothelial cell density following exposure to 1%, 2%, and 5% concentrations of PI in a porcine model. Four groups of excised porcine corneas were exposed to 1% (group A), 2% (group B), and 5% (group C) PI and balanced salt solution (BSS, Alcon Labs, Fort Worth, TX) (group D) for a 1-minute exposure. Specular microscopy was used to measure endothelial cell density pre- and post-exposure. Group A (1% PI) had reduction of endothelial cell density from 3870 cells/mm2 to 3604 cells/mm2, group B (2%) 3634 preexposure to 3115 postexposure, group C (5%) 3582 preexposure to 2948 postexposure, and group D (BSS) endothelial cell density was 3639 preexposure to 3741 postexposure. A graded increase in endothelial cell loss is seen with increased povidone iodine concentrations.