Chitaranjan Mishra1, Prajna Lalitha2, Gunasekaran Rameshkumar2, Rupesh Agrawal3, Praveen Kumar Balne4, Mani Iswarya5, Naresh Babu Kannan1, Kim Ramasamy1. 1. a Department of Vitreo-retina Services , Aravind Eye Hospital , Madurai , Tamil Nadu , India. 2. b Department of Ocular Microbiology , Aravind Eye Hospital , Madurai , Tamil Nadu , India. 3. c National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore. 4. d Translational Pre-Clinical Model Platform , Singapore Eye Research Institute , Singapore. 5. e Department of Biostatistics , Aravind Eye Hospital , Madurai , Tamil Nadu , India.
Abstract
PURPOSE: To report the incidence and characteristics of endophthalmitis after intravitreal injections (IVI) of antivascular endothelial growth factor agents and triamcinolone acetonide. METHODS: Patients' medical records were retrospectively reviewed from January 2009 to June 2016, and the incidence, risk factors, clinical and microbiological characteristics of post-IVI endophthalmitis were evaluated. RESULTS: The total number of intravitreal injections given, which included ranibizumab, bevacizumab, and triamcinolone acetonide, was 20,566, of which 27 cases developed endophthalmitis, giving an overall incidence of 0.131%. Significant reduction (p < 0.003) in incidence of endophthalmitis was observed in patients who received prefilled compounded bevacizumab injections (0.050%) compared to multiple bevacizumab injections from a single vial (0.235%). In the triamcinolone acetonide group, the incidence was 0.26%. Staphylococcus species were isolated from 18 cases (67%), and all strains were sensitive to vancomycin. CONCLUSIONS: Adherence to strict aseptic protocols and use of prefilled compounded bevacizumab injections reduces the rate of post-IVI endophthalmitis.
PURPOSE: To report the incidence and characteristics of endophthalmitis after intravitreal injections (IVI) of antivascular endothelial growth factor agents and triamcinolone acetonide. METHODS:Patients' medical records were retrospectively reviewed from January 2009 to June 2016, and the incidence, risk factors, clinical and microbiological characteristics of post-IVI endophthalmitis were evaluated. RESULTS: The total number of intravitreal injections given, which included ranibizumab, bevacizumab, and triamcinolone acetonide, was 20,566, of which 27 cases developed endophthalmitis, giving an overall incidence of 0.131%. Significant reduction (p < 0.003) in incidence of endophthalmitis was observed in patients who received prefilled compounded bevacizumab injections (0.050%) compared to multiple bevacizumab injections from a single vial (0.235%). In the triamcinolone acetonide group, the incidence was 0.26%. Staphylococcus species were isolated from 18 cases (67%), and all strains were sensitive to vancomycin. CONCLUSIONS: Adherence to strict aseptic protocols and use of prefilled compounded bevacizumab injections reduces the rate of post-IVI endophthalmitis.
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