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- Title
No increase in incidence of post-intravitreal injection endophthalmitis without topical antibiotics: a prospective study.
- Authors
Tanaka, Koji; Shimada, Hiroyuki; Mori, Ryusaburo; Nakashizuka, Hiroyuki; Hattori, Takayuki; Okubo, Yuko
- Abstract
Purpose: In our previous report, intravitreal injection using 0.25% povidone-iodine to irrigate the conjunctival sac together with pre- and post-injection topical antibiotics achieved an incidence of post-injection endophthalmitis significantly lower than other reports. In this study, we examined whether similarly low incidence is achieved without using any topical antibiotics. Study design: Prospective cohort study. Methods: We evaluated intravitreal injections of anti-vascular endothelial growth factor agents conducted by vitreoretinal specialists at the outpatient injection room of a single university hospital. This study had two protocols. First stage: We performed more than 3000 injections with pre-injection but without post-injection topical antibiotics. Final stage: After confirming no case of endophthalmitis in the first stage, we performed more than 12,500 injections without either pre- or post-injection topical antibiotics. In both protocols, we used 0.25% povidone-iodine to sterilize the conjunctival sac both before and after injection. Results: First stage was performed between April 2015 and January 2016. No case of suspected or proven infectious endophthalmitis occurred in 6039 injections [95% confidence interval (CI) 0–0.000497%]. Final stage was performed between February 2016 and November 2017. No case of suspected or proven infectious endophthalmitis occurred in 12,523 injections (95% CI 0–0.00024%). This result was comparable to our previous study using both pre- and post-injection topical antibiotics (0/15,144 injections, 95% CI 0–0.000198%). Conclusion: Using conjunctival sac irrigation with 0.25% povidone-iodine before and after intravitreal injection, the incidence of endophthalmitis remains low even when the use of pre- or post-injection topical antibiotics is discontinued.
- Subjects
ENDOTHELIAL growth factors; LONGITUDINAL method; ANTIBIOTICS; INJECTIONS; VASCULAR endothelial growth factors
- Publication
Japanese Journal of Ophthalmology, 2019, Vol 63, Issue 5, p396
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-019-00684-5