Vladimir Poposki_SCIENTIFIC POSTER 2015

Introduction:

The endophthalmitis is a devastating complication of intravitreal injection (IVI) procedure. Topical antibiotics are used by consensus and protocol, because of supposed advantage of its use in the reduction of conjunctival bacterial growth. However, this benefit is controversial. Many studies concluded that they do not alter the incidence nor reduce the risk of endophthalmitis. Even more, its repeated use in sub-inhibitory concentrations could start development of resistant and more virulent bacterial strains. Our main objective was to determine the incidence of endophthalmitis following IVI, and its relation to antibiotic prophylaxis.

Material & Methods:

In a pilot, prospective and randomized study, 522 intravitreal injections were performed at 340 subjects, divided into two groups. Patients who met the established criteria for anti-VEGF treatment, also met our inclusion criteria. The study group included 169 patients without topical antibiotics prophylaxis in the perioperative period, and the control group was composed of 171 patients who instilled antibiotic eye drops. The first group received 264, and the second one 258 IVI. Injections were prepared in a sterile room, immediately before application. All patients underwent 10% povidone-iodine periocular cleaning and 5% povidone-iodine conjunctival hygiene. The injection technique included use of speculum, sterile gloves and mask. After IVI procedure three visits control were made – on days 3, 7 and 30.

Results:

Demographic data was homogeneous and comparable. There were no significant differences between mean age and sex. The vast majority were patients with AMD: 70% (study group) and 76% (control group). 26.5% of all studied patients (both groups) had other retinal vascular disease. No patient in either group was suspicious for infection nor had presentation of severe eye infection during the follow-up period.

Conclusion:

We do not recommend the routine use of antibiotic prophylaxis with intravitreal injections. The sterile environment and proper aseptic technique are sufficient to prevent endophthalmitis.

Contact Details:

Email: vpoposki@hotmail.com
Cell Phone: +34653633547

Vladimir Poposki