The effect of ocular rinse volume on surface irritation after povidone-iodine preparation for intravitreal injections: a randomized controlled trial

Purpose To evaluate whether the volume of wash out rinse after povidone iodine (PI) application for intravitreal injections (IVI) affects patients’ ocular surface irritation. Methods This was a prospective, single-masked, randomized-controlled trial consisting of 142 subjects. A total of 51, 45, and 46 patients received 3-mL, 10-mL, and 15-mL of ocular rinse respectively. Reductions in the Ocular Surface Disease Index (OSDI) and the Standardized Patient Evaluation of Eye Dryness II (SPEED II) surveys, conducted before and at 24–72 h post-injection, were analyzed. Results There was no statistical difference in objective dry eye findings of Schirmer test ( p -value = 0.788), tear break-up time ( p -value = 0.403), Oxford fluorescein grade ( p -value = 0.424) between the study groups prior to injections. Dry eye symptoms as measured by reductions in the OSDI and SPEEDII scores were not different between the study groups (p-value = 0.0690 and 0.6227, respectively). Conclusion There is no difference in patients’ ocular surface irritation between 3-mL, 10-mL, and 15-mL post injection rinse. Given the large number of IVIs performed, modification of practice patterns based on these findings could lead to significant reduction in global cost burden for IVIs.