Hypochlorous acid antiseptic washout improves patient comfort after intravitreal injection: A patient reported outcomes study

PURPOSE: Current ocular antiseptic practice for intravitreal injection (IVI) employs 5% povidone–iodine (Betadine(®)) drops which frequently cause ocular discomfort and prolonged irritation. In an effort to improve comfort while maintaining efficacy, we studied a hypochlorous acid (HOCL 0.01%) spray washout prior to injection. METHODS: Patients had received a minimum of 3 IVIs prepared with Betadine(®) antisepsis prior to entry in this study. Their subsequent IVIs were prepared with Betadine(®) followed by HOCL 0.01% washout. Facets of comfort were measured by a Likert-scaled questionnaire to compare their experiences after IVI. RESULTS: Thirty-seven participants were enrolled. Addition of HOCL 0.01% spray after Betadine(®) reduced the duration of discomfort (P = 0.001) and need for artificial tears postinjection (P = 0.003). It improved their reported quality of life (P = 0.04) and sleep (P = 0.01). There were neither HOCL-related side effects nor endophthalmitis during this study. CONCLUSION: Topical HOCL 0.01% spray after topical Betadine(®) antisepsis significantly improved patient comfort following IVIs.