Using 2% PVPI topical solution for serial intravitreous injections and ocular surface findings: a case control study

Area of Science:

• Ophthalmology
• Ocular Surface Disease
• Medical Microbiology

Background:

• Povidone-iodine (2%) is commonly used for ocular surface antisepsis before intravitreal injections.
• Frequent intravitreal injections lead to repeated exposure to iodinated solutions.
• The impact of repeated povidone-iodine use on ocular surface health requires investigation.

Purpose of the Study:

• To investigate ocular surface changes in patients undergoing repeated intravitreal injections with povidone-iodine antisepsis.
• To analyze the effects on Ocular Surface Disease Index (OSDI), non-invasive tear break-up time (NIBUT), blinking quality, lipid layer, tear meniscus height, and osmolarity.
• To compare outcomes between treated eyes and untreated contralateral eyes.

Main Methods:

• Case-control study involving 34 participants (68 eyes).
• Inclusion criteria: individuals receiving 2% povidone-iodine eyedrops for intravitreal injections, with the contralateral eye as control.
• Ocular surface examinations performed once post-protocol application; statistical analysis using STATA® 18.0.

Main Results:

• No statistically significant differences were observed in OSDI, NIBUT, blinking quality, lipid layer thickness, tear meniscus height, or osmolarity between treated and untreated eyes.
• Median number of intravitreal injections (IVIs) in treated eyes was 12 (range 6-20).
• No statistically significant relationship found between repetitive 2% iodinated solution use and dry eye syndrome symptoms.

Conclusions:

• 2% povidone-iodine is a safe and effective agent for ocular surface antisepsis in intravitreal injections.
• The repeated use of povidone-iodine does not lead to substantial ocular surface modifications.
• Continued use of povidone-iodine in ophthalmic procedures is supported, without increased risk of dry eye syndrome.