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Background <p>To evaluate the impact of repeated exposure to 5 percent povidone iodine on meibomian gland atrophy in eyes receiving intravitreal injections.</p> Methods <p>Patients undergoing intravitreal injections with a standardised protocol that included 5% povidone-iodine instillation in one eye were prospectively enroled. Eligible patients had received their last injection within the previous 12 weeks. Patients were stratified according to the number of prior injections. Those with systemic conditions or medications affecting ocular surface parameters were excluded. Assessments included Keratograph 5 M meibography, slit lamp examination, and Schirmer testing at baseline, one hour, and seven days after injection. Meibomian gland atrophy was quantified using ImageJ software. Statistical analysis included repeated-measures ANOVA, regression modelling, and interobserver agreement.</p> Results <p>A total of 143 patients with a mean age of 69 years were included. Age-related macular degeneration was the predominant diagnosis, and treat and extend was the most common protocol. In the study eye, tear meniscus height, bulbar hyperaemia, and Schirmer scores increased, while tear breakup time decreased at one hour post-injection. These changes were most evident in patients with fewer than five or more than thirteen prior injections and resolved by day seven. Meibography revealed reduced gland atrophy, especially in the inferior eyelid. Regression analysis showed a small but significant inverse association between injection number and gland atrophy.</p> Conclusions <p>Patients with more intravitreal injections and greater exposure to 5% povidone-iodine showed less meibomian gland atrophy, particularly in the inferior eyelid, along with improved ocular surface parameters.</p>

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Ocular surface and meibomian gland changes following repeated exposure to 5% povidone-iodine during intravitreal injections

  • 期刊论文

  • 发表日期：

    2026年8月5日

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  • Raul Velez-Montoya,
  • Alejandro Cruz-Gonzalez,
  • Gerardo Pedraza-Rivera,
  • Ana Mercedes García-Albisua,
  • Katherine Massiel Ureña-Tejeda,
  • Ramses Rosales-Díaz,
  • Xiadani Lucero-De la Rosa,
  • Jose Eduardo Pineda-Pérez,
  • Salvador Hernández-Castellanos,
  • Karen Guevara-Flores,
  • Abel Ramirez-Estudillo,
  • Carlos Ivan Campos-Wolter,
  • Vladimir Angel Marte-Ramirez,
  • Gerardo Ledesma-Gil,
  • Alejandro Navas,
  • Jesus Hernán González-Cortés,
  • Karim Mohamed-Noriega,
  • Nallely Ramos-Betancourt

摘要

Background

To evaluate the impact of repeated exposure to 5 percent povidone iodine on meibomian gland atrophy in eyes receiving intravitreal injections.

Methods

Patients undergoing intravitreal injections with a standardised protocol that included 5% povidone-iodine instillation in one eye were prospectively enroled. Eligible patients had received their last injection within the previous 12 weeks. Patients were stratified according to the number of prior injections. Those with systemic conditions or medications affecting ocular surface parameters were excluded. Assessments included Keratograph 5 M meibography, slit lamp examination, and Schirmer testing at baseline, one hour, and seven days after injection. Meibomian gland atrophy was quantified using ImageJ software. Statistical analysis included repeated-measures ANOVA, regression modelling, and interobserver agreement.

Results

A total of 143 patients with a mean age of 69 years were included. Age-related macular degeneration was the predominant diagnosis, and treat and extend was the most common protocol. In the study eye, tear meniscus height, bulbar hyperaemia, and Schirmer scores increased, while tear breakup time decreased at one hour post-injection. These changes were most evident in patients with fewer than five or more than thirteen prior injections and resolved by day seven. Meibography revealed reduced gland atrophy, especially in the inferior eyelid. Regression analysis showed a small but significant inverse association between injection number and gland atrophy.

Conclusions

Patients with more intravitreal injections and greater exposure to 5% povidone-iodine showed less meibomian gland atrophy, particularly in the inferior eyelid, along with improved ocular surface parameters.