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Response to correspondence from Koerner and colleagues concerning our paper entitled: The effect of diluting povidone-iodine on bacterial growth associated with speech
BMC Ophthalmology volume 20, Article number: 328 (2020)
Clinicians adopt varying strategies for antisepsis with PI, which to this day remains efficient, economical and effective. Clinicians should prudently consider effective PI application, and we thank Koerner and Grzybowski for encouraging debate and raising the profile of this issue.
We thank Koerner and Grzybowski  for their comments regarding the study on the effect of diluting povidone-iodine (PI) on bacterial growth associated with speech . We agree that there are no standardized reliable ways to simulate the ocular surface to analyse this in vitro, and stress that the emphasis of this study design is to add to the evidence base. This study demonstrated the differences in PI dilution and significant bacterial culture growth with bacterial droplet dispersal associated with speech. Whilst there is evidence to suggest lower doses of PI is effective , we note that other evidence suggest that these lower doses require several applications . Clinicians adopt varying strategies for antisepsis with PI, which to this day remains efficient, economical and effective . Clinicians should prudently consider effective PI application, and we again thank Koerner and Grzybowski for encouraging debate and raising the profile of this issue.
Availability of data and materials
The dataset used and/or analysed during the current study are available from the corresponding author on reasonable request. All data generated or analysed during this study are included in this published article.
Koerner J, Grzybowski A. Povidone-iodine pharmacokinetics and study design. BMC Ophthalmol. 2020;20(1):29.
Gnanasekaran S, Rogers S, Wickremasinghe S, Sandhu SS. The effect of diluting povidone-iodine on bacterial growth associated with speech. BMC Ophthalmol. 2019;19(1):62.
Koerner JC, George MJ, Kissam EA, Rosco MG. Povidone-iodine concentration and in vitro killing time of bacterial corneal ulcer isolates. Digit J Ophthalmol. 2018;24(4):24–6.
Silas MR, Schroeder RM, Thomson RB, Myers WG. Optimizing the antisepsis protocol: effectiveness of 3 povidone-iodine 1.0% applications versus a single application of povidone-iodine 5.0. J Cataract Refract Surg. 2017;43(3):400–4.
Grzybowski A, Kanclerz P, Myers WG. The use of povidone-iodine in ophthalmology. Curr Opin Ophthalmol. 2018;29(1):19–32.
The Centre for Eye Research Australia receives operational infrastructure support from the Victorian Government. The funder had no role in our study.
Ethics approval and consent to participate
This study was originally approved by The Royal Victorian Eye and Ear Hospital’s human research ethics committee and involved a series of healthy participants. Written informed consent was obtained from all study participants.
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The authors declare that they have no competing interests.
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Gnanasekaran, S., Rogers, S., Wickremasinghe, S. et al. Response to correspondence from Koerner and colleagues concerning our paper entitled: The effect of diluting povidone-iodine on bacterial growth associated with speech. BMC Ophthalmol 20, 328 (2020). https://doi.org/10.1186/s12886-020-01599-3
- Intravitreal injection
- Pre-injection antisepsis