Efficacy and safty of an ozonated solution used preoperatively to disinfect the ocular surface, and to irrigate the corneal flap in laser in situ keratomileusis

Purpose: To evaluate the efficacy and safety of an ozonated solution used as a preoperative disinfectant and to irrigate the corneal flap in laser in situ keratomileusis. Methods: In normal human eyes, the rates of positive bacterial culture before and after irrigation were compared for 3 kinds of solutions: a 1:16 solution of povidone-iodine, a hypotonic-ozonated solution, and an isotonic-ozonated solution. In white rabbit eyes, the conjunctival fomix of the eye was irrigated with one of the 3 solutions before a corneal flap was made. Then the flap was irrigated with one of these 3 solutions: a hypotonic-ozonated solution, an isotonicozonated solution, or a balanced salt solution (BSS). The degree of corneal epithelial damage, the degree of edema in the flap after irrigation, and postoperative wound healing were compared in rabbit eyes exposed to the 3 solutions. Results: In human eyes, all 3 solutions were effective preoperative disinfectants. In rabbit eyes, the degree of corneal damage was more severe in the eyes irrigated with povidone iodine solution than in those irrigated with other solutions. There was no noticeable difference in the degree of flap edema after irrigation under the flap or in wound healing among eyes irrigated with BSS or an ozonated solution. Conclusions: An ozonated solution is an effective preoperative disinfectant and causes less corneal damage than a povidone iodine solution. An isotonic ozonated solution could be used to irrigate under the corneal flap during laser in situ keratomileusis.