title: Effect of a Strict 'No-Talking' Policy During Intravitreal Injection on Post-Injection Endophthalmitis.
abstract: OBJECTIVE
  To report the effect of a "no-talking" policy during intravitreal injection (IVI) on post-injection endophthalmitis.
  
  
  METHODS
  Retrospective, comparative, consecutive case series of patients receiving IVI between Jan. 1, 2009, and Dec. 31, 2012. A 24-month "usual care" period was compared to a 24-month no-talking period, during which a strategy to further minimize speech during IVI was implemented.
  
  
  RESULTS
  During the usual care period, 47,155 IVIs were performed, with nine culture-positive cases (0.019%), including seven due to oral pathogens (0.015%). During the no-talking period, 82,658 IVIs were performed, with eight culture-positive cases (0.010%), including two due to oral pathogens (0.002%). The no-talking policy was associated with a decreased endophthalmitis risk (P = .004), including oral pathogen-associated endophthalmitis (P = .02).
  
  
  CONCLUSIONS
  This study demonstrates that a more stringent no-talking policy during IVI may reduce the risk of post-injection endophthalmitis.
authors.forename: Sunir J
authors.initials: SJ
authors.lastname: Garg
authors.forename: Michael
authors.initials: M
authors.lastname: Dollin
authors.forename: Jason
authors.initials: J
authors.lastname: Hsu
authors.forename: Philip
authors.initials: P
authors.lastname: Storey
authors.forename: James F
authors.initials: JF
authors.lastname: Vander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D000068258:Bevacizumab / Q000627:therapeutic use; D009877:Endophthalmitis / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology*; D016134:Organizational Policy; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians'; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D013060:Speech / Q000502:physiology*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D000900:Anti-Bacterial Agents; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab