title: Bimanual assisted eyelid retraction technique for intravitreal injections.
abstract: OBJECTIVE
  To describe an alternative technique for avoiding contact with the lids and eyelashes without the use of a metal lid speculum along with the results in clinical practice.
  
  
  METHODS
  Retrospective review of the medical records of all patients undergoing intravitreal injections of bevacizumab and ranibizumab with lid retraction achieved by bimanual assisted eyelid retraction between November 2010 and December 2011.
  
  
  RESULTS
  A total of 10,164 consecutive intravitreal injections were performed, of which 3,834 were bevacizumab and 6,330 were ranibizumab. In this cohort of patients, 3 suspected cases of endophthalmitis developed (2 culture-negative), corresponding to a rate of 0.03%.
  
  
  CONCLUSIONS
  The technique of bimanual assisted eyelid retraction for intravitreal injection has a low rate of infection similar to the reported rates using a metal lid speculum.
authors.affiliation: Retina Service, Wills Eye Institute, Philadelphia, Pennsylvania.
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Fineman
authors.forename: Jason
authors.initials: J
authors.lastname: Hsu
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Spirn
authors.forename: Richard S
authors.initials: RS
authors.lastname: Kaiser
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000890:Anti-Infective Agents / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000068258:Bevacizumab; D004866:Equipment Contamination / Q000517:prevention & control; D005143:Eyelids / Q000502:physiology*; D006801:Humans; D058449:Intravitreal Injections / Q000295:instrumentation / Q000379:methods*; D011206:Povidone-Iodine / Q000008:administration & dosage; D000069579:Ranibizumab; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D000779:Anesthetics, Local; D020533:Angiogenesis Inhibitors; D000890:Anti-Infective Agents; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D011206:Povidone-Iodine; D000069579:Ranibizumab