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Surgeon shares pearls for performing intravitreal injections
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 Elias Reichel |
As the use of intravitreal injections increases, newer techniques in sterilization and anesthesia are being recommended to avoid complications.
At Hawaiian Eye 2011, Elias Reichel, MD, discussed trends and tips for intravitreal injections.
"Intravitreal injection use is skyrocketing," Dr. Reichel said. "The sterile technique that we use and anesthesia choice are important for avoiding endophthalmitis."
It is especially important to keep the field sterile to reduce the risk of bacterial endophthalmitis, Dr. Reichel said. He advised sweeping povidone-iodine on the lids, lashes and eye before injection and always using a lid speculum with adequate topical anesthetic.
Dr. Reichel said physicians should avoid injecting patients who have active infections and avoid extensive massage of the lids before injection.
Prophylactic paracentesis is not necessary and just adds a step to the procedure, Dr. Reichel said.
Dr. Reichel warned against talking, breathing or coughing at the time of injection, as a recent series of cases suggests this could increase the risk of streptococcus.
Early recognition and treatment of endophthalmitis are critical for a successful outcome, he said. Therefore, it is highly important that patients know the signs and symptoms and are able to self-report issues.
- Disclosure: Dr. Reichel receives royalties from Akorn.
Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.