June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Endophthalmitis rate following intravitreal injections before and after the adoption of COVID-19 universal masking
Author Affiliations & Notes
  • Matthew Pfannenstiel
    Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, United States
  • Shreeya Dalla
    Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, United States
  • Mary Champion
    Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, United States
  • Martin A Mainster
    Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, United States
  • Radwan Ajlan
    Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, United States
  • Footnotes
    Commercial Relationships   Matthew Pfannenstiel None; Shreeya Dalla None; Mary Champion None; Martin Mainster None; Radwan Ajlan None
  • Footnotes
    Support  Grant: CTSA Award # UL1TR002366. Support: Healthcare Enterprise Repository for Ontological Narration (HERON)
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 5275. doi:
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    • Get Citation

      Matthew Pfannenstiel, Shreeya Dalla, Mary Champion, Martin A Mainster, Radwan Ajlan; Endophthalmitis rate following intravitreal injections before and after the adoption of COVID-19 universal masking. Invest. Ophthalmol. Vis. Sci. 2023;64(8):5275.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Intravitreal injection (IVI) is a common ophthalmic office procedure. Post-injection endophthalmitis (PIE) is an infrequent but serious complication of IVI. Most but not all clinical studies support the wearing of face masks by patients, physicians, and staff (i.e., universal masking) during IVI. Moreover, studies have reported that universal masking may decrease the rate of culture-positive PIE, if not the rate of PIE overall. The purpose of this study is to compare rates of PIE at a tertiary referral center before and after the implementation of universal masking for the COVID-19 pandemic.

Methods : A retrospective chart review was conducted for all patients receiving IVI at a single institution from August 1st, 2017 to December 15th, 2022. All injections were performed by one of two faculty vitreoretinal specialists. A “no-talking policy” was employed during IVI. Universal masking was implemented for the COVID-19 pandemic beginning on April 10th, 2020. Charts were reviewed for cases of suspected or proven PIE.

Results : A total of 9,848 IVIs were performed for 908 patients (481 females, 427 males). Average patient age was 67.4 years old, ranging from 16 to 102 years old. Average number of injections per patient was 10.8. Three cases of PIE were identified before universal masking was implemented and one case was identified afterward. Vitreous tap cultures were positive for Staphylococcus epidermidis in one patient who received IVI prior to universal masking implementation. The three other cases of PIE were culture negative. None of the PIE cases occurred with brolucizumab. All patients with PIE were treated promptly with vancomycin 1mg/0.1ml and ceftazidime 2.25mg/0.1ml IVIs.

Conclusions : We found a low incidence of PIE at a single institution before and after universal masking was adopted for the COVID-19 pandemic. Masking did not eliminate PIE. Our PIE rate is similar to those reported previously. Prospective studies are needed to clarify the effect of universal masking on PIE.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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