Abstract
Purpose: :
To evaluate the safety of using single unit dose topical anesthetic eye drops versus single use Lidocaine gel prior to intravitreal injection.
Methods: :
The contents from 60 consecutive bottles of Tetracaine Hydrochloride Ophthalmic Solution 0.5% Viscous Sterile Solution were cultured after use for topical anesthesia prior to intravitreal injections. Next, the contents from 52 consecutive tubes of Lidocaine Hydrochloride gel, USP 2% were cultured after using these in patients for topical anesthesia prior to intravitreal injections. The length of time the tube/bottle was open, and the number of patients anaesthetized, was evaluated.
Results: :
No growth was found in any of the 60 bottles of the Tetracaine drops; however, 7 of the Lidocaine gel tubes were culture-positive; six for coagulase negative staphylococci and one for Klebsiella oxytoca. None of the patients with the culture positive tubes developed endophthalmitis. The drops were open 1-19 days, and 386 patients were anaesthetized. The Lidocaine gel was open 1-44 days, and 209 patients were anaesthetized.
Conclusions: :
The use of preservative-free 2% Lidocaine gel may increase the risk of endophthalmitis following intravitreal injection as a result of anesthetic contamination, whereas the use of preserved single unit dose topical tetracaine anesthetic drops in multiple patients did not result in infectious contamination of the drops.
Keywords: macula/fovea • age-related macular degeneration • injection