*Jules Gonin Eye Hospital, Lausanne, Switzerland; Departments of †Ophthalmology, and ‡Infectiology, Triemli Hospital Zurich, Zurich, Switzerland; and §Graf Biostatistics, Winterthur, Switzerland.
Retina. 2014 Jan;34(1):12-7. doi: 10.1097/IAE.0b013e31829f74b0.
To evaluate the incidence of presumed endophthalmitis (EO) after intravitreal injection (IVI) of anti-vascular endothelial growth factor agents performed in the operating room.
Retrospective study at 2 Swiss eye hospitals between 2004 and 2012. Hospital records were used to identify patients treated with an IVI of an anti-vascular endothelial growth factor agent between 2004 and 2012 and those treated for EO, defined as any intraocular inflammation treated with intravitreal antibiotics. All IVIs were performed using standard sterile technique in a Swiss Class 1 operating room. No patient received preinjection topical antibiotics. Postinjection topical antibiotics were used only in one hospital.
A total of 40,011 IVIs were performed at the 2 centers during the study period. Of the IVIs, ranibizumab was injected in 36,398 (91%), bevacizumab in 3,518 (9%), aflibercept in 89 (0.2%), and pegaptanib in 6 (<0.1%). Three cases of post-IVI presumed EO occurred, yielding a combined incidence of 0.0075% per injection (95% confidence interval: 0.0026-0.0220%) or 1 case per 13,337 IVIs. Two of the three cases of EO occurred in patients using post-IVI antibiotics. All three cases followed ranibizumab injection and were culture negative by anterior chamber tap or vitreous biopsy.
The risk of EO after IVI performed under the sterile conditions of the operating room was very low.
评估在手术室行抗血管内皮生长因子药物玻璃体内注射（IVI）后推定眼内炎（EO）的发生率。
2004 年至 2012 年在瑞士的 2 家眼科医院进行的回顾性研究。使用医院记录来识别 2004 年至 2012 年间接受抗血管内皮生长因子药物 IVI 治疗的患者和因 EO 而接受治疗的患者，EO 定义为用玻璃体内抗生素治疗的任何眼内炎症。所有 IVI 均在瑞士 1 级手术室中采用标准无菌技术进行。没有患者在注射前接受局部抗生素治疗。注射后仅在一家医院使用局部抗生素。
在研究期间，这 2 家中心共进行了 40011 次 IVI。在这些 IVI 中，雷珠单抗注射 36398 次（91%），贝伐单抗注射 3518 次（9%），阿柏西普注射 89 次（0.2%），和哌加他尼注射 6 次（<0.1%）。发生了 3 例推定的 IVI 后 EO，每注射 1 次的合并发生率为 0.0075%（95%置信区间：0.0026-0.0220%），或每 13337 次 IVI 发生 1 例。3 例 EO 中有 2 例发生在使用 IVI 后抗生素的患者中。所有 3 例 EO 均继发于雷珠单抗注射，且通过前房穿刺或玻璃体活检培养均为阴性。
在手术室无菌条件下进行 IVI 后发生 EO 的风险非常低。
