The Patient Experience: 5% Povidone-Iodine vs 0.05% Aqueous Chlorhexidine.

Area of Science:

• Ophthalmology
• Infectious Disease Prevention
• Patient Experience Research

Background:

• Intravitreal injections require antiseptic preparation.
• Povidone-iodine (PI) is a common antiseptic, but can cause ocular discomfort.
• Aqueous chlorhexidine (aqCHX) is being explored as a potentially gentler alternative.

Purpose of the Study:

• To compare patient experiences and tolerability of aqCHX versus PI for intravitreal injection antisepsis.
• To evaluate differences in ocular pain, irritation, vision changes, and overall satisfaction.

Main Methods:

• A single-center patient survey was conducted.
• 141 patients receiving PI and 92 patients receiving aqCHX for intravitreal injections were surveyed.
• Patient-reported outcomes including pain, irritation, vision changes, and satisfaction were compared.

Main Results:

• Patients receiving aqCHX reported significantly less ocular pain and irritation at one hour (P=.005) and one day (P=.027) post-injection compared to PI.
• Greater patient satisfaction was reported with aqCHX (P=.014).
• A lower frequency of participants experienced worsened vision with aqCHX (19.6%) versus PI (33.6%, P=.02).

Conclusions:

• Aqueous chlorhexidine (aqCHX) demonstrates improved tolerability and patient experience compared to povidone-iodine (PI) for intravitreal injection antisepsis.
• The findings suggest aqCHX may be a preferable antiseptic agent for patients undergoing intravitreal injections.
• Further research could validate these patient-reported outcomes in larger, multi-center trials.