Prophylaxis measures for postinjection endophthalmitis

Surv Ophthalmol. 2020 Jul-Aug;65(4):408-420. doi: 10.1016/j.survophthal.2019.12.005. Epub 2020 Jan 7.

Abstract

Intravitreal injections have become the most commonly performed ophthalmic procedure, transforming modern retina practice. Postinjection endophthalmitis, while rare, remains the most feared potential complication. Prophylaxis measures including topical antisepsis, hand hygiene, gloves, masks, and drapes have all been proposed to help prevent postinjection endophthalmitis; however, there remains significant variation in protocol, given the lack of agreement among retina specialists on which steps are crucial to prevent endophthalmitis. With millions of injections performed annually, collating data have helped us better understand risk factors for endophthalmitis after intravitreal injection. We summarize the consensus guidelines for intravitreal injection technique and comprehensively review the literature on prevention of postinjection endophthalmitis.

Keywords: anti-VEGF; endophthalmitis; intravitreal injection; postinjection; povidone-iodine; steroids.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods*
  • Endophthalmitis / etiology
  • Endophthalmitis / prevention & control*
  • Eye Infections, Bacterial / etiology
  • Eye Infections, Bacterial / prevention & control*
  • Humans
  • Intravitreal Injections / adverse effects

Substances

  • Anti-Bacterial Agents