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. 2021 Dec 1;47(12):651-654.
doi: 10.1097/ICL.0000000000000828.

Effect of Repeated Topical Povidone-Iodine and Antibiotic Applications on Meibomian Glands and Ocular Surface Parameters in Patients With Repeated Intravitreal Injections

Osman A Polat  1 , Zekeriya Çetinkaya, Cem Evereklioğlu, Çağatay Karaca, Kuddusi Erkiliç
Affiliations

Effect of Repeated Topical Povidone-Iodine and Antibiotic Applications on Meibomian Glands and Ocular Surface Parameters in Patients With Repeated Intravitreal Injections

Osman A Polat et al. Eye Contact Lens. .

Abstract

Objectives: To assess whether meibomian glands and ocular surface parameters are affected by repeated topical povidone-iodine and antibiotic applications in patients with repeated intravitreal injections.

Methods: Forty-five patients with at least three previous intravitreal injections and 28 healthy controls were included in the study. In the injection group, 21 patients had age-related macular degeneration and 24 patients had diabetic macular edema. For each participant, infrared meibography for the upper and lower eyelids and noninvasive tear break-up time calculation were performed with a corneal topographer. Fluorescein tear break-up time and ocular surface disease index (OSDI) scores were also obtained. Noninvasive tear break-up time, fluorescein tear break-up time, and OSDI scores were recorded for each participant and compared between the injection and control groups. These parameters were also compared as a subgroup analysis between patients with age-related macular degeneration (AMD) and diabetic macular edema (DME).

Results: Upper lid meibomian gland loss, lower lid meibomian gland loss ratios, and OSDI scores were significantly higher in the intravitreal injection group compared with the control group (P=0.004, P<0.001, P<0.001, respectively). Fluorescein tear break-up time and noninvasive tear break-up time were significantly lower in the intravitreal injection group compared with the control group (P<0.001, P<0.001). There was no significant difference between the AMD and DME groups for these parameters.

Conclusion: This study showed for the first time that meibomian gland losses were significantly increased by repeated povidone-iodine and antibiotic applications in patients with repeated intravitreal injections. Ocular surface parameters were altered with higher ocular surface symptoms in those patients.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

    1. Schargus M, Frings A. Issues with intravitreal administration of anti-VEGF drugs. Clin Ophthalmol 2020;14:897–904.
    1. Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: A systematic review and meta-analysis. Lancet Glob Health 2014;2:e106–e116.
    1. Nentwich MM, Ulbig MW. Diabetic retinopathy—ocular complications of diabetes mellitus. World J Diabetes 2015;6:489–499.
    1. Saedon H, Nosek J, Phillips J, et al. Ocular surface effects of repeated application of povidone iodine in patients receiving frequent intravitreal injections. Cutan Ocul Toxicol 2017;36:343–346.
    1. Ali FS, Jenkins TL, Boparai RS, et al. Aqueous chlorhexidine compared to povidone iodine as ocular antisepsis prior to intravitreal injection: A randomized clinical trial. Ophthalmol Retina 2020;20:30458–30459.