Intravitreal injection analysis at the Bascom Palmer Eye Institute: evaluation of clinical indications for the treatment and incidence rates of endophthalmitis.
OBJECTIVE
To report the incidence of endophthalmitis, in addition to its clinical and microbiological aspects, after intravitreal injection of vascular-targeting agents.


METHODS
A retrospective review of a consecutive series of 10,142 intravitreal injections of vascular targeting agents (bevacizumab, ranibizumab, triamcinolone acetonide, and preservative-free triamcinolone acetonide) between June 1, 2007 and January 31, 2010, performed by a single service (TGM) at the Bascom Palmer Eye Institute.


RESULTS
One case of clinically-suspected endophthalmitis was identified out of a total of 10,142 injections (0.009%), presenting within three days of injection of bevacizumab. The case was culture-positive for Staphylococcus epidermidis. Final visual acuity was 20/40 after pars plana vitrectomy surgery.


CONCLUSIONS
In this series, the incidence of culture-positive endophthalmitis after intravitreal injection of vascular agents in an outpatient setting was very low. We believe that following a standardized injection protocol, adherence to sterile techniques and proper patient follow-up are determining factors for low incidence rates.
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School, of Medicine, Miami, FL, USA.
Ludimila L
LL
Cavalcante
Milena L
ML
Cavalcante
Timothy G
TG
Murray
Michael M
MM
Vigoda
Yolanda
Y
Piña
Christina L
CL
Decatur
R Prince
RP
Davis
Lisa C
LC
Olmos
Amy C
AC
Schefler
Michael B
MB
Parrott
Kyle J
KJ
Alliman
Harry W
HW
Flynn
Andrew A
AA
Moshfeghi