Comparison between the Efficacy and Tolerability of Polyvinylpyrrolidone-Iodine Eye Drops 0.6% and 1% in Adenoviral Keratoconjunctivitis: A Randomized Clinical Trial.

Purpose: To investigate the effect of topical Polyvinylpyrrolidone-iodine (PVP-I) 0.6% on the clinical course of adenoviral keratoconjunctivitis compared with PVP-I 1% and artificial tears.

Methods: We prospectively enrolled all patients over 18 years of age with a polymerase chain reaction (PCR)-confirmed diagnosis of adenoviral keratoconjunctivitis who presented to the hospital between November 2022 and June 2023. Patients were randomized into 3 groups: artificial tears (control), PVP-I 1%, and PVP-I 0.6% eye drops, 4 times daily for 5 days. Clinical signs at presentation and at 6 follow-up visits during the 1^st 3 weeks of the acute phase were recorded. Patients were also followed up at 1 and 3 months.

Results: Ninety-four patients completed the study, of which 30, 31, and 33 were in the control, PVP-I 1%, and PVP-I 0.6% groups, respectively. The mean age of the patients was 37.2 years (interquartile range: 25-46). The PCR result was positive in 75.6% of patients with the clinical suspicion. PVP-I, regardless of the concentration, was superior to the artificial tears in terms of time to resolution of lid swelling, discharge, and incidence of subsequent subepithelial infiltrates (P < 0.05). However, a concentration of 0.6% was equivalent to 1%. No significant adverse events were reported in any group.

Conclusions: The PVP-I 0.6% topical drops are safe and well tolerated in patients with acute adenoviral keratoconjunctivitis. It can be substituted for the 1% solution as it has comparable effects in improving the clinical course and reducing subsequent complications.