Efficacy Of Povidone-Iodine 1% In The Treatment Of Anterior Blepharitis- A Randomized Controlled Trial

Anterior blepharitis is a chronic inflammation of the eyelid margin. Despite various treatments centered on proper eyelid hygiene, no definitive cure exists. Povidone-Iodine (PVI) aqueous solution is an antiseptic agent commonly utilized in ophthalmology. However, controlled trials examining the effectiveness of PVI in treating blepharitis are lacking. This study aimed to evaluate the safety and efficacy of lid scrub with PVI 1% ophthalmic solution versus dedicated eyelid wipes in treating anterior blepharitis.

Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel.

In this randomized, controlled, observer-masked, paired-eye trial, 49 patients with anterior blepharitis were randomly assigned to receive once daily lid scrub with PVI 1% ophthalmic solution in one eye (treatment group) and dedicated eyelid wipes in the fellow eye (control group) for 30 days. Patients were evaluated at baseline and at day 30. Clinical outcome measures were blepharitis signs (eyelid edema, erythema, crusting), tear break-up time (TBUT), and corneal staining (NEI score). Symptoms were assessed using the visual analog scale (VAS score) for each eye and ocular surface disease index (OSDI) questionnaire. Adverse events were also documented.

Forty patients completed the treatment and were analyzed, while 5 patients were lost to follow-up, 3 were non-compliant, and 1 suffered an eye trauma. The mean age of participants was 61.6 years, and 47% were female. At the end of the 30-day treatment period, both the treatment and control groups exhibited significant improvements in symptoms, blepharitis signs, TBUT, and corneal staining (p<0.001). PVI 1% solution was equally effective as the dedicated eyelid wipes in all measured outcomes (p=0.603). Only the treatment group showed a positive correlation between improvements in the OSDI score and the VAS score (r=0.43, p=0.005). No adverse events related to PVI 1% treatment were reported.

Our preliminary results indicate that PVI 1% is an effective, safe, and well-tolerated treatment option for anterior blepharitis.