Abstract
Purpose :
Dry Eye Syndrome can be caused or aggravated by chemical aggression. We performed an observational case-control study to evaluate the risk of the repetitive use of povidone iodine (PVPI) used for ocular asepsis in serial eye anti-VEGF intravitreal injections (IVIs).
Methods :
The study included 34 individuals (68 eyes), 14 males, 20 females, aged 48 to 94. Inclusion criteria were individuals who received application of 2% PVPI eye drops for anti-VEGF IVIs treatment with the contralateral eye, used as control, that has not been treated with any topical medication during the same period of applications. Exclusion criteria included incapacity of understanding the Ocular Surface Disease Index Questionnaire (OSDI); use of antidepressant medicine, diuretics, sympathomimetics, eye drops for glaucoma or use of eye lubricants; allergy to iodine. The exams performed were capture of blinking quality images, tear film interferometry, the height of the tear meniscus, noninvasive breakup time (NBUT), Meibomian gland (MG) loss, and tear osmolarity. All statistical analyses were performed using STATA® 18.0 Software. The Shapiro-Wilk test was used for normality. The Wilcoxon Rank-Sum test was used for non normal distribution data and the Student’s t-test for data that showed normality.
Results :
The average number of IVIs in treated eyes was 9.15 (range, 2–63). The results in treated eyes compared with untreated eyes were respectively for mean OSDI 23.56±7.29 and 21.37±6.14 (p=0.830); NBUT 10.30±2.62 and 10.78±2.92 (s, p=0.476); blinking quality 98.23±1.71 and 91.5±8.91 (%, p=0.188); lipid layer 80.56±5.62 and 83.44±5.73 (nm, p=0.451); meniscus height 0.26±0.05 and 0.25±0.03 (mm, p=0.862); MG loss 35.4±5.35 and 34.0±5.28 (%, p=0.524); and, Osmolarity 305.6±9.04 and 313.8±12.41 (mOsm, p=0.297). There was no statistically significant relationship between the repetitive use of 2% iodinated solution and signs or symptoms compatible with dry eye syndrome in this group of patients.
Conclusions :
The use of iodine on the ocular surface was not statistically related to any parameter we use to evaluate dry eye syndrome. A local anti-inflammatory and protective surface effect of the anti VEGF used in IVIs should be considered and further studies with repetitive use of PVPI in different eye procedures will be needed to support these results.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.