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Similar endophthalmitis rates seen in operating rooms, offices after intravitreal injections
Rates of endophthalmitis after intravitreal injections were similarly low in operating room settings and office settings, according to a study.
“Although many of these precautions make clinical sense, there is no direct evidence that precautions, such as use of a surgical drape, sterile gloves, face masks, preinjection antibiotics, nor postinjection antibiotics make a clinically significant difference to the rate of endophthalmitis,” the study authors said.
Researchers analyzed medical records and billing databases for a case series of 11,710 intravitreal injections that took place in office settings (8,647) or operating room settings (3,063) from 2009 to 2011. Subjects in both groups were diagnosed with neovascular age-related macular degeneration, diabetic macular edema, retinal vein occlusion or other conditions, and were treated with Lucentis (ranibizumab, Genentech), Avastin (bevacizumab, Genentech) or triamcinolone acetonide.
In the office-based setting, physicians used nonsterile disposable gloves, and there were no restrictions on conversation. Surgical masks, sterile drapes and preop topical antibiotics were not used. In the operating room setting, sterile gloves, surgical masks, drapes and eyelid speculums were used. There were restrictions on conversation.
Three cases patients in the office-based group (0.035%) and two cases in the operating room group (0.065%) required treatment for endophthalmitis between 3 days and 20 days after intravitreal injection. The difference between the two groups was not significant.
Disclosure: The authors have no relevant financial disclosures.