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A. R. Bhavsar, G. G. Emerson, M. V. Emerson; A Consecutive Series of 7,540 Intravitreous Injections Without Topical Antibiotic Prophylaxis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6047.
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To assess the results of a consecutive series of 7,540 intravitreous injections without topical antibiotic prophylaxis.
The data from 7,540 consecutive intravitreous injections performed by a single surgeon, including demographics, diagnosis, medication given and safety outcomes including endophthalmitis were retrospectively analyzed. All injections were given with topical proparacaine and tetracaine, topical povidone iodine conjunctival prep (pre- and post-injection), a sterile eyelid speculum and clean non-sterile gloves, but without any topical antibiotics prior to, during or after the intravitreous injections.
2,182 patients were treated with 7,540 intravitreous injections. 1,371 patients were female and 811 were male. 3,776 right eyes and 3,764 left eyes were treated. The mean age of the patients was 79 years. 5,728 injections of bevacizumab, 1,074 injections of ranibizumab, 489 injections of triamcinolone acetonide, and 249 injections of pegaptanib sodium were administered. All injections were administered with pre- and post-injection topical povidone iodine on the conjunctival surface but without topical antibiotics prior to, on the day of or after the injection.The largest number of injections was performed for exudative age-related macular degeneration. Less common causes included diabetic macular edema and cystoid macular edema due to retinal vein occlusions and other diseases.There were no cases of endophthalmitis. There were no cases of retinal detachment.Secondary uveitis developed in 11 eyes. Steroid responder glaucoma occurred in 37 eyes after triamcinolone acetonide injection. Secondary glaucoma developed in 1 eye after bevacizumab injection. 7,540 consecutive intravitreous injections of bevacizumab, ranibizumab, triamcinolone and pegaptanib sodium were given by a single surgeon without any cases of endophthalmitis.
Intravitreous injections may be administered safely with topical povidone iodine conjunctival prep but without topical antibiotic prophylaxis.
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