Universal masking showed reduction in endophthalmitis during intravitreal injections
WAIKOLOA, Hawaii — Universal mask use showed to be an effective prevention method for endophthalmitis during intravitreal injections, according to a speaker here at Hawaiian Eye 2022.
Sunir J. Garg, MD, FACS, the co-director of retina research at Wills Eye Hospital in Philadelphia, said that intravitreal injections are the most common procedure performed by ophthalmologists.
In the U.S. in 2001, just 5,000 injections were performed, but they have increased annually, with over 6 million injections given in 2016.
Incidence of endophthalmitis ranges between one case in every 1,300 to 1,500 injections, Garg said. Two-thirds to three-fourths of endophthalmitis cases come from bacteria in the eyelids and/or conjunctiva. Prevention is critical, he said.
“Most cases of endophthalmitis come from the patient’s own eyelids and eyelashes,” Garg said.
In a retrospective review of 505,968 injections across 12 centers, Garg and colleagues assessed cases of endophthalmitis from Oct. 1, 2019, through July 31, 2020.
When comparing 294,514 injections in those who wore no face masks with 211,454 injections with a universal face mask policy in place, there were 85 cases of endophthalmitis in the group with no masks, and 45 cases in those who did.
Following cultures, there were 27 positive cases with three from oral flora in the group with no masks, and 9 cases with none attributed to oral flora in the group who did.
“The take home message is, universal face masks were associated with less endophthalmitis and less culture positive endophthalmitis than standard of care,” Garg said. “The big question is, will we continue [mask use]?”
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Garg SJ. What intravitreal injections have taught us about endophthalmitis. Presented at: Hawaiian Eye; Jan. 15-21, 2022; Waikoloa, Hawaii.
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