The Efficacy of Combined Povidone Iodine 1% and Dexamethasone 0.08% Prepared Eye Drops in Treating Post Viral Corneal Sub Epithelial Infiltrates Compared to Other Modalities of Treatments

Abstract

Purpose: To Evaluate the efficacy of combination povidone-iodine 1.0% eye drops and dexamethasone 0.08% eye drops in the treatment of post viral corneal Sub Epithelial Infiltrates (SEIs). Materials and methods: A prospective, randomized, controlled, comparative study was conducted at king Hussein medical center between 2020-2021. Patients who attended to the ophthalmology department suffering from SEIs were enrolled in the study; a written Informed consent was obtained from all enrolled patients. Inclusion criteria include; ≥ 18 years of age, SEIs duration more than one month and less than 6 months, one eye per patient were included in the study and naive eye. Exclusion criteria include; a history of thyroid disease, allergy to iodine or study medications, ocular surgery within the past 3 months, corneal dendrites, conjunctival membrane or pseudo membrane, active conjunctivitis, corneal ulceration, corneal abrasion, corneal foreign body, anterior chamber inflammation or pregnancy/lactating mother. Patients were randomly divided into three groups and treated for two weeks. In the first group, patients received combined povidone iodine 1% and dexamethasone 0.08% prepared eye drops with lubricant eye drops, the second group received dexamethasone 0.08% eye drops and lubricants eye drops and the third group received povidone iodine 1% eye drops and lubricant eye drops. The patients were followed up and evaluated at day zero, 2 weeks, 6 weeks, 6 months’ post treatment regarding; Best Corrected Visual Acuity (BCVA), Intraocular Pressure (IOP), symptoms (visual blurring, photophobia, and foreign body sensation) and corneal sub epithelial infiltrates according to our scoring scale. Results: After conducting the inclusion and exclusion criteria, 45 eyes were included in the study (15 in each group). Povidone iodine 1% was well tolerated and safe in first and third groups. In first study group, a dramatic improvement in patients’ symptoms and SEIs scoring scale was observed (p < 0.05) in addition to a significant improvement in BCVA after 2 weeks of treatment. On the other side, no significant improvement has been achieved (p > 0.05) regarding BCVA, symptoms or SEIs scoring scale in the second and third groups. Conclusion: Combined povidone iodine 1% and dexamethasone 0.08% prepared eye drops can improve signs and symptoms of SEIs in addition to a significant improvement in BCVA and speeding up the recovery compared to the other modalities of treatment used in this study.