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R. M. Patel, A. Pani, B. Freund, J. Levine; Habits of Retina Specialists in Performing Intravitreal Injections. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5128.
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To determine the practices of retina specialists performing intravitreal injections.
A questionnaire addressing the various aspects of pre-injection, injection, and post-injection care was distributed to retina specialists attending the Wills Eye Institute Retina Club meeting on 11/14/2009 and to those known to us in the New York area by postal mail or email. The collected data was compiled anonymously and statistically analyzed.
Forty-one questionnaires were completed. Please see tables for results:
Given 29.2% of surgeons had patients suffer from endophthalmitis after an intravitreal injection, it is ideal to have one standardized protocol to minimize such complications.As shown in the data, some believe the use of topical antibiotics days before will decrease bacterial counts of the ocular flora. Others avoid this pre-treatment as many believe this may select out antibiotic-resistant strains of bacteria increasing the possibility of endophthalmitis. 58.5% perform betadine lid scrubs prior to injection and 43.9% use sterile gloves indicating there is no agreement on whether these measures actually decreases infection rates.Variability in the use of viscous anesthetics reflects a belief that while it may increase patient comfort, it may also prevent the efficacy of the betadine prep, prevent adequate intraocular penetration of a topical antibiotic, or even harbor bacteria in itself.The data set reveals the varying schools of thought on how intravitreal injections should be performed. Given the increasing rate of injections being performed today, it would be of great benefit to have a consensus on the appropriate techniques for this procedure to keep complication rates to a minimum.
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