Casemiro José Henrique, Oguido Ana Paula Miyagusko Taba, Casella Antonio Marcelo Barbante
Postgraduate Program in Health Sciences, State University of Londrina, UEL, Londrina, Brazil.
Department of Health Sciences, Surgical Clinic, State University of Londrina, UEL, Londrina, Brazil.
Int J Retina Vitreous. 2024 May 29;10(1):41. doi: 10.1186/s40942-024-00557-1.
The use of povidone-iodine for ocular surface asepsis is widespread for intravitreal injections. They became frequent procedures, leading to serial exposure of patients' eyes to iodinated solutions. In this study, we investigate the changes in the ocular surface in patients submitted to repeated use of povidine for intravitreal injection of anti-VEGF asepsis, analyzing Ocular Surface Disease Index, non-invasive break up time, blinking quality, lipid layer, meniscus height and osmolarity.
This case-control study included 34 individuals (68 eyes), 14 males, 20 females aged 48 to 94. Inclusion criteria were individuals who received application of 2% povidone-iodine eyedrops for intravitreal injections treatment with the non-treated contralateral eye used as control. Ocular surface examinations were performed at a single occasion. A pre-intravitreal injection asepsis protocol with povidone-iodine was applied. All statistical analysis was performed using the STATA® 18.0 Software and a p-value = 0.05 was considered as the statistical significance value in all tests.
The median number of IVIs in treated eyes was 12 (range 6-20). The results in treated eyes compared with untreated eyes were respectively : median OSDI 16 (IQR 6-39) and 12.5 (IQR 8-39) (p = 0.380); mean NIBUT 10.30 (SD ± 2.62) and 10.78 (SD ± 2.92) ( s, p = 0.476); median blinking quality 100 (IQR 100) and 100 (IQR 100 ) (%, p = 0.188); median lipid layer 87 (IQR 77-90) and 86 (IQR 74-100) (nm, p = 0.451); median meniscus height 0.22 (IQR 0.19-0,31) and 0.24 (IQR 0.20-0.27) (mm, p = 0.862), median Meibomian gland atrophy 33 (IQR 24-45) and 31.5 (IQR 25-39) (%, p = 0.524); and mean osmolarity 306.6 (SD ± 21.13) and 313.8 (SD ± 29) (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.
The findings suggest that 2% povidone iodine is a safe and efficacious agent for ocular surface antisepsis during intravitreal injections, not leading to substantial ocular surface modifications. This conclusion supports the continued use of povidone iodine in routine ophthalmic procedures without increased risk of inducing dry eye syndrome.
聚维酮碘用于眼内注射时眼表消毒十分普遍。眼内注射已成为常见操作，导致患者眼睛多次接触含碘溶液。在本研究中，我们调查了反复使用聚维酮进行抗血管内皮生长因子（VEGF）眼内注射消毒的患者眼表变化，分析了眼表疾病指数、非侵入性泪膜破裂时间、眨眼质量、脂质层、泪河高度和渗透压。
本病例对照研究纳入了34名个体（68只眼），其中男性14名，女性20名，年龄在48至94岁之间。纳入标准为接受过2%聚维酮碘滴眼液用于眼内注射治疗的个体，以未治疗的对侧眼作为对照。仅进行一次眼表检查。采用含聚维酮碘的眼内注射前消毒方案。所有统计分析均使用STATA® 18.0软件进行，所有检验中p值 = 0.05被视为具有统计学意义。
治疗眼的眼内注射中位数为12次（范围6 - 20次）。治疗眼与未治疗眼的结果分别为：眼表疾病指数中位数16（四分位间距6 - 39）和12.5（四分位间距8 - 39）（p = 0.380）；平均非侵入性泪膜破裂时间10.30（标准差±2.62）和10.78（标准差±2.92）（秒，p = 0.476）；眨眼质量中位数100（四分位间距100）和100（四分位间距100）（%，p = 0.188）；脂质层中位数87（四分位间距77 - 90）和86（四分位间距74 - 100）（纳米，p = 0.451）；泪河高度中位数0.22（四分位间距0.19 - 0.31）和0.24（四分位间距0.20 - 0.27）（毫米，p = 0.862），睑板腺萎缩中位数33（四分位间距24 - 45）和31.5（四分位间距25 - 39）（%，p = 0.524）；平均渗透压306.6（标准差±21.13）和313.8（标准差±29）（毫摩尔，p = 0.297）。在该组患者中，2%含碘溶液的重复使用与干眼综合征相关体征或症状之间无统计学显著关系。
研究结果表明，2%聚维酮碘是眼内注射时眼表消毒的一种安全有效的药物，不会导致眼表显著改变。这一结论支持在常规眼科手术中继续使用聚维酮碘，且不会增加诱发干眼综合征的风险。
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