Abstract
Purpose :
To evaluate one year incidence of post- intravitreal injection related endophthalmitis without pre or post injection antibiotic cover.
To compare efficacy of 5% Povidone-iodine solution against Chlorhexidine as an effective antiseptic agent in post-intravitreal injection endophthalmitis.
To assess the incidence rate of endophthalmitis at different sites of injection (superotemporal vs. inferotemporal) in last 5 years.
All injections were performed by trained ophthalmic nurses under supervision of Medical Retina specialist doctor.
Methods :
This is a longitudinal retrospective, case-note review study of all patients diagnosed with post- intravitreal injection endophthalmitis.
To evaluate one year incidence of post- intravitreal injection related endophthalmitis, we reviewed data from Mar 2014-Apr 2015. All injections were performed by ophthalmic trained nurses without pre or post topical antibiotic cover, only a single stat dose of topical Chloramphenicol given at the time of injection.
To compare, the efficacy of 5% Povidone-iodine solution against Chlorhexidine as an antiseptic agent and endophthalmitis incidence at different site of intravitreal injection, all cases of intravitreal injection related endophthalmitis over last 5 years (2011-2015) were reviewed.
Results :
During one year study period (2014-2015), total of 24,113 injections were performed and out of those 03 cases of endophthalmitis were reported (0.0124% per injection).Our cohort showed very low incidence rate of post-intravitreal infective endophthalmitis without any antibiotic cover. These figures are lower than previously published studies (0.025%).
Looking at a 5 year study period, out of 73,338 injections,18 eyes were identified as having post-intravitreal injection endophthalmitis (1 in 4074) . In 13 out of 18 cases Povidone-Iodine was used while Chlorhexidine being used in the other 5 cases. Chlorhexidine was only used when patients were believed to be allergic to Iodine. An equal number of cases of endopthalmitis occurred in those injected superiorly and inferiorly (9 in each group).
Conclusions :
Our real-world cohort showed a low rate of post- intravitreal injection endophthalmitis (1in 8000) without antibiotic cover. Povidone-iodine was used in majority of eyes with overall low incidence rate of endophthalmitis.There was no difference noted in rate of endophthalmitis at different intravitreal injection sites.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.