September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Impact of practice modifications on infectious endophthalmitis rates following intravitreal injection of anti-vascular endothelial growth factor
Author Affiliations & Notes
  • Maya Maloney
    Mayo Clinic, Rochester, Minnesota, United States
  • Andrew Barkmeier
    Mayo Clinic, Rochester, Minnesota, United States
  • Sophie J Bakri
    Mayo Clinic, Rochester, Minnesota, United States
  • Raymond Iezzi
    Mayo Clinic, Rochester, Minnesota, United States
  • Jose Pulido
    Mayo Clinic, Rochester, Minnesota, United States
  • Wendy Smith
    Mayo Clinic, Rochester, Minnesota, United States
  • Jay Erie
    Mayo Clinic, Rochester, Minnesota, United States
  • Footnotes
    Commercial Relationships   Maya Maloney, None; Andrew Barkmeier , None; Sophie Bakri, Allergan (C); Raymond Iezzi, Alcon (C); Jose Pulido, None; Wendy Smith, None; Jay Erie, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3360. doi:
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      Maya Maloney, Andrew Barkmeier, Sophie J Bakri, Raymond Iezzi, Jose Pulido, Wendy Smith, Jay Erie; Impact of practice modifications on infectious endophthalmitis rates following intravitreal injection of anti-vascular endothelial growth factor. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3360.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the effectiveness of practice modifications in reducing infectious endophthalmitis rates among patients undergoing intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF).

Methods : A retrospective review of all cases of clinically suspected endophthalmitis after intravitreal injection of anti-VEGF from January 2011 through September 2015 was performed. In May 2013, practice modifications to the intravitreal injection practice were implemented and included the mandatory use of masks by nurses and physicians while in injection rooms, conversion to a sterile instrument tray setup, room cleaning between all patients by using Oxivir TB disinfectant wipes (Diversey, Inc., Sturtevant, WI), and converting injections from an office-based setting to an outpatient surgery center setting. Chi-square testing was used to compare endophthalmitis rates before and after implementation of practice changes.

Results : Before practice modifications, 9 cases of clinically suspected endophthalmitis were identified after a total of 17,008 injections (0.05%; January 1, 2011 through April 30, 2013). Following implementation of practice modifications, 2 cases of endophthalmitis was identified after 24,229 injections (0.008%; P=<0.009; May 1, 2013 through September 30, 2015).

Conclusions : Post-intravitreal injection endophthalmitis rate was significantly reduced following practice modifications that included the use of masks by nurses and physicians, conversion to a sterile instrument tray setup, room cleaning between all patients, and converting injections to an outpatient surgery center setting. It is unclear which of these modifications, if any, are responsible for the decreased endophthalmitis rate.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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