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Prefilled anti-VEGF injection may reduce risk of endophthalmitis
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PHILADELPHIA — Mounting evidence from an ongoing multicenter collaboration demonstrates that anti-VEGF injection via prefilled syringe may substantially reduce the risk of endophthalmitis compared with the conventional method of injection, Philip Storey, MD, MPH, said at the Wills Eye Conference.
Storey and colleagues conducted a retrospective case-control study of all patients with endophthalmitis at Wills Eye Hospital following a conventional vs. prefilled syringe method of delivering Lucentis (ranibizumab, Genentech) over a 2-year period. The incidence of endophthalmitis when injections were given via prefilled syringe was one in 7,084, whereas incidence was one in 2,767 when the injection was given by conventional method.
“The odds of endophthalmitis infection was 2.5 times higher with the conventional medication than with the prefilled medication,” Storey said. “However, our P value is .13, which does not meet statistical significance. If you told me you had something that would take my endophthalmitis rate from 1 in 2,700 to 1 in 7,000, I’d say, ‘Sign me up, that sounds great.’ However, we don’t meet statistical significance because this is a very uncommon event.”
To strengthen the power of the investigation, Storey and colleagues at Wills Eye Hospital are collaborating with nine other institutions to pool their data.
Preliminary data from the combined effort thus far demonstrate an incidence of endophthalmitis of one in 9,050 after injection with a prefilled syringe vs. one in 3,413 with the conventional method of injection. The odds ratio is 2.65 and the P value is much closer to statistical significance, .062, with more data pending, Storey said.
“It does seem that eliminating the transfer of medication from vial to syringe may actually reduce our risk of endophthalmitis,” Storey said. – by Patricia Nale, ELS
Reference:
Storey P. Do prefilled syringes decrease the risk of endophthalmitis with intravitreal injection? A case-control study. Presented at: Wills Eye Conference; March 8 to 10, 2018; Philadelphia.
Disclosure: Storey reports no relevant financial disclosures.