Department of Ophthalmology, Seoul National University, South Korea.
Retina. 2012 Apr;32(4):667-71. doi: 10.1097/IAE.0b013e31822c296b.
To evaluate the safety of bilateral same-day intravitreal injections using a single vial and to introduce a molecular surveillance system to screen bacterial drug contamination using eubacterial polymerase chain reaction (PCR).
Retrospective review of the medical records of 135 patients who received 574 bilateral same-day intravitreal injections for various retinal diseases in 2 tertiary referral hospitals between January 2008 and March 2010 was performed. Data were obtained regarding the diagnosis, kinds of drugs injected, postinjection complications, and the result of molecular bacterial screening of the injected drugs. Drugs for bilateral intravitreal injections were drawn from a single vial and injected using separate syringes or needles. Molecular bacterial screening was performed using the remaining drug in the syringe by 16S ribosomal DNA real-time PCR.
A total of 574 injections (384 bevacizumab, 154 ranibizumab, and 36 triamcinolone) were administered on bilateral eyes of 135 patients. There were no complications, including endophthalmitis, uveitis, retinal tear, or retinal detachment. Of the 278 injections screened for bacterial contamination using eubacterial PCR, no cases (0%) showed drug contamination by bacteria. The sensitivity of eubacterial PCR for molecular bacterial screening was 10 colony-forming units (CFUs)/mL or lower.
Bilateral same-day intravitreal injections drawn from a single vial using separate syringes or needles are well tolerated by patients, and its safety profile may be equivalent to unilateral injections. The bacterial molecular surveillance system using eubacterial PCR demonstrated the safety of bilateral same-day intravitreal injections and may be used for safety surveillance and for timely intervention of possible drug-related endophthalmitis.
评估使用单支小瓶进行双眼同日玻璃体腔内注射的安全性，并引入一种细菌药物污染的分子监测系统，使用真核生物聚合酶链反应（PCR）进行筛查。
对 2008 年 1 月至 2010 年 3 月期间在 2 家三级转诊医院因各种视网膜疾病接受 574 例双眼同日玻璃体腔内注射的 135 例患者的病历进行回顾性分析。获取的资料包括诊断、注射药物种类、注射后并发症以及注射药物的分子细菌筛查结果。双眼玻璃体腔内注射药物均来自单支小瓶，使用单独的注射器或针头进行注射。通过实时 16S 核糖体 DNA PCR 对注射器内剩余药物进行分子细菌筛查。
共对 135 例患者的双眼进行了 574 例注射（384 例贝伐单抗、154 例雷珠单抗和 36 例曲安奈德）。无眼内炎、葡萄膜炎、视网膜裂孔或视网膜脱离等并发症发生。使用真核生物 PCR 对 278 例注射药物进行细菌污染筛查，均未发现（0%）药物受细菌污染。真核生物 PCR 用于分子细菌筛查的灵敏度为 10 个菌落形成单位（CFU）/mL 或更低。
使用单独的注射器或针头从单支小瓶中抽取药物进行双眼同日玻璃体腔内注射，患者耐受性良好，其安全性与单侧注射相当。使用真核生物 PCR 的细菌分子监测系统证实了双眼同日玻璃体腔内注射的安全性，可用于安全性监测和及时干预可能与药物相关的眼内炎。
