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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-08-2013 | Retinal Disorders

Minimizing the endophthalmitis rate following intravitreal injections using 0.25 % povidone–iodine irrigation and surgical mask

Authors: Hiroyuki Shimada, Takayuki Hattori, Ryusaburo Mori, Hiroyuki Nakashizuka, Kyoko Fujita, Mitsuko Yuzawa

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2013

Abstract

Background

To examine the efficacy of complying with an infection control manual for intravitreal injection of anti-vascular endothelial growth factor (VEGF) preparations in reducing the rate of endophthalmitis.

Methods

We retrospectively reviewed intravitreal anti-VEGF injections conducted by vitreoretinal specialists at the outpatient injection room of a single university hospital between July 2009 and July 2012. The injections were conducted following an infection control manual established by our department. Doctors and nurses wore surgical masks, and disinfected the patient’s eyelid skin with 10 % povidone–iodine and then the conjunctiva with 0.25 % povidone–iodine. After putting a drape on the patient’s face, a lid speculum was placed. The conjunctival surface was again washed with 5 ml of 0.25 % povidone–iodine. After waiting at least 30 seconds, intravitreal injection was performed through povidone–iodine. Following injection, the injection site was again washed with 5 ml of 0.25 % povidone–iodine. Patients were treated with topical levofloxacin 4 times a day for 3 days before and after the injection.

Results

A total of 15,144 injections comprising 548 injections of pegaptanib sodium, 846 injections of bevacizumab, and 13,750 injections of ranibizumab were performed. During this period, no case of suspected or proven infectious endophthalmitis occurred. The endophthalmitis rate was 0 per 15,144 injections, (95 % confidence interval, 0.0–0.0 %).

Conclusion

The results suggest that endophthalmitis can be reduced to a minimum by preventing normal flora of the conjunctiva and bacteria in the oral cavity from entering the vitreous. For this purpose, an infection control manual that requires nurses and doctors to wear surgical mask and drape the patient’s face, irrigate the conjunctiva with 0.25 % povidone–iodine and wait at least 30 seconds before performing intravitreal injection is useful.

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Title: Minimizing the endophthalmitis rate following intravitreal injections using 0.25 % povidone–iodine irrigation and surgical mask
Authors: Hiroyuki Shimada
Takayuki Hattori
Ryusaburo Mori
Hiroyuki Nakashizuka
Kyoko Fujita
Mitsuko Yuzawa
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 8/2013
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-013-2274-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minimizing the endophthalmitis rate following intravitreal injections using 0.25 % povidone–iodine irrigation and surgical mask

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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