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H. D. Perry, G. S. Stoller, K. B. Carnevale, S. McCormick, M. Shah, S. A. Berger, E. D. Donnenfeld; Prospective Investigation of Intravitreal Injection Needles Cultured Immediately Following Injection of Corticosteroids, AvastinR or Lucentis R. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5021.
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To determine the incidence of positive cultures from intravitreal injection needles used to deliver steroids, AvastinR, or LucentisR.
200 Consecutive patients are having their intravitreal needles cultured following intravitreal injection with steroids, AvastinR or LucentisR. Immediately following injection the surgeon using the same needle and syringe aspirates 0.5cc of Thioglycollate solution and inoculates the vial. Detailed cultures were (are)performed on Blood, Chocolate, Thioglycollate broth and Saboraud media. Positive cultures were noted and speciated.
Positive cultures were found in 8 patients from the first 53 injections thusly evaluated (15%). 4 Staph epidermidis, 2 E coli, Klebsiella pneumoniae and Strep fecalis.
Contamination of intravitreal injection needles is much more frequent than the development of endophthalmitis post injection (1/1000-1/2500). This finding parallels the findings of positive anterior chamber cultures after phacoemulsification surgery (7-17%) and subsequent endophthalmitis 1/400-1/2500.
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