Iodide iontophoresis as a treatment for dry eye syndrome

Abstract

Background/aims: Among the causes related to the development or perpetuation and aggravation of dry eye disease, oxidative reactions may have a role in the pathogenesis of this disorder. Antioxidants, such as iodide, have shown a strong effect in preventing the oxidative damage to constituents of the anterior part of the eye. In this clinical trial the effectiveness of iodide iontophoresis and iodide application without current in moderate to severe dry eye patients was compared. Methods: 16 patients were treated with iodide iontophoresis and 12 patients with iodide application without current for 10 days. Subjective improvement, frequency of artificial tear application, tear function parameters (break up time, Schirmer test without local anaesthesia), vital staining (fluorescein and rose bengal staining) as well as impression cytology of the bulbar conjunctiva were evaluated before treatment, 1 week, 1 month, and 3 months after treatment. Results: A reduction in subjective symptoms, frequency of artificial tear substitute application, and an improvement in certain tear film and ocular surface factors could be observed in both groups. A stronger positive influence was seen after application of iodide with current (iontophoresis), as observed in a distinct improvement in break up time, fluorescein and rose bengal staining, and in a longer duration of this effect compared with the non-current group. No significant change in Schirmer test results and impression cytology were observed in both groups. Conclusions: Iodide iontophoresis has been demonstrated to be a safe and well tolerated method of improving subjective and objective dry eye factors in patients with ocular surface disease.

Recent Advances in Ophthalmic Drug Delivery

“…Ocuphor (Iomed Inc., USA) and Visulex (Aciont Inc., USA) are the other ocular iontophoresis systems under investigation for trans-scleral iontophoresis. Harwath-Winter et al demonstrated the superiority of ocular iontophoresis for the delivery of sodium iodide in treating dry eye syndrome in 28 patients [99]. The investigators observed no corneal edema or epithelial damage in this study.…”

The effect of iodide iontophoresis on the antioxidative capacity of the tear fluid

“…Also an improvement in tearfilm break-up time and fluorescein and rose bengal staining of the ocular surface was observed in dry-eye patients after iodide iontophoresis [5] The amount of iodide in the tissues of the ocular surface and a possible depot effect may explain the sustained improvement of dry eye complaints of the patients seen for a longer period of up to 6 months or longer [54]. It was reported that iodide binds to some of the connective tissue components such as collagen [55].…”

“…The significant improvement of the antioxidative protective capacity of the tear fluid by iodide iontophoresis in Bad Hall/ Austria is certainly an essential expansion of the treatment of dry eye syndrome, especially in cases with oxidative stress to the ocular surface [5,9,21,31,32,54,57,61,64] Further investigations are needed to elucidate iodine effects on other factors of dry eye disorders, for instance inflammation, which is another important finding in dry eye syndrome.…”

“…Today, the cause of this disease is seen as a multifactorial event, and related to the pathologic condition of any of the parts of the functional unit, including the tear film, the ocular surface (conjunctiva, cornea, accessory lacrimal glands and meibomian glands), the main lacrimal glands, and the interconnecting neural reflex loops [4][5][6]. Dry eye is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.…”

Jodsole-Therapie aus ophthalmologischer und internistischer Sicht. 150 Jahre Landeskuranstalten, 55 Jahre Paracelsus-Institut, 50 Jahre Augenabteilung Bad Hall

“…Dabei wurde mit einem lontophorese-System Iodid in das Auge gebracht and mit einer Kontrollgruppe verglichen, der Iodid ohne Stromanwendung appliziert wurde [104]. In dieser Studie warden 56 Augen von 28 konsekutiven Patienten mit moderatem bis schwerem trockenen Auge, mit oder ohne Sjogren-Sydrom, vor and nach Iodid-Elektrophorese, in einer dreimonatigen Follow-up-Periode untersucht.…”