„Iodallergie“

Abstract

Preoperative disinfection with povidone-iodine results in asignificant reduction of the risk for postoperative endophthalmitis and secondary irreversible vision loss in intraocular surgeries and intravitreal injections. Nevertheless, this important measure is often omitted if so-called "iodine allergy" is suspected. We analyze the physiological and allergological basis for the construct of "iodine allergy". This article is based on aselective literature review using the search term "allergy" in combination with "iodine", "povidone", "indocyanine green", or "seafood". Iodine is achemical element and an essential component of the human body. Scientific proof for the existence of an antibody-mediated allergic reaction (typeI reaction) and in particular an immunoglobulin (Ig) E‑mediated anaphylaxis against iodine is lacking. Chemical irritations and contact allergies (typeIV reaction) induced by iodine-containing disinfectants are not antibody-mediated and do not cause anaphylaxis (typeI reaction). The uncommon antibody-mediated allergies against iodine-containing disinfectants, fluorescent dyes, radiocontrast media, or seafood are not directed against the contained iodine itself but against other components of the respective formulation. Thus, allergic cross-reactivities between these different substance groups are not to be expected. So-called "iodine allergy" is amedical myth lacking ascientific basis and should not result in increased patient risks due to omitted preoperative disinfection.