Lau P Et, Jenkins K S, Layton C J
College of Medicine and Dentistry, James Cook University, Townsville, Australia.
Greenslopes Clinical School, Faculty of Medicine, University of Queensland, Brisbane, Australia.
J Ophthalmol. 2018 Jul 24;2018:8567912. doi: 10.1155/2018/8567912. eCollection 2018.
Intravitreal injection of a therapeutic substance is the most common procedure performed in ophthalmology. It has a low incidence of serious complications but is associated with a small chance of endophthalmitis. Although the rate of endophthalmitis is between 0.019% and 0.09%, the associated visual morbidity is often devastating. Procedural changes have evolved over the years to improve patient comfort and reduce injection-related injury and infection. Despite the availability of published evidence, there remains considerable variations and lack of consensus in practical clinical settings. In addition, emerging literature concerning the use of speculums, the use of prophylactic topical antibiotics, and the setting of injections continues to impact the ophthalmologist's injection practice. This article provides an up to date assessment of various aspects of the procedure such as the setting, ventilation, type of anaesthetic, and control of sterility during the procedure; including discussions on performing bilateral eye same-day injections and the use of antibiotics.
玻璃体内注射治疗性物质是眼科最常见的操作。其严重并发症发生率较低，但存在发生眼内炎的小概率风险。尽管眼内炎发生率在0.019%至0.09%之间，但相关的视力损害往往是毁灭性的。多年来，操作流程不断改进，以提高患者舒适度，减少注射相关损伤和感染。尽管有已发表的证据，但在实际临床环境中仍存在相当大的差异且缺乏共识。此外，有关窥器使用、预防性局部抗生素使用以及注射环境的新文献继续影响眼科医生的注射操作。本文对该操作的各个方面进行了最新评估，如操作环境、通风、麻醉类型以及操作过程中的无菌控制；包括关于双侧眼同日注射和抗生素使用的讨论。
