眼内注射后伴或不伴局部抗生素预防的眼内炎发生率。

Incidence of endophthalmitis after intravitreal injection with and without topical antibiotic prophylaxis.

机构信息

Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal.

Faculty of Medicine, University of Porto, Porto, Portugal.

出版信息

Eur J Ophthalmol. 2021 Mar;31(2):600-606. doi: 10.1177/1120672120902028. Epub 2020 Feb 4.

DOI:10.1177/1120672120902028

PMID:32019339

Abstract

PURPOSE

The purpose was to compare the incidence of endophthalmitis after intravitreal injection with and without topical antibiotic prophylaxis.

METHODS

This is a single-center, retrospective case-control study. All patients treated with intravitreal injection of ranibizumab, bevacizumab, aflibercept, or corticosteroids for a variety of retinal vascular diseases between 1 October 2014 and 30 November 2018 were included. The total number of patients and injections were determined from a review of billing code and practice management records. Endophthalmitis cases were determined from billing records and then confirmed with chart review. A 24-month period when topical antibiotics were prescribed after intravitreal injection was compared with a 24-month period when topical antibiotics were not prescribed.

RESULTS

Between 1 October 2014 and 30 November 2018, a total of 33,515 intravitreal injections were performed and 13 cases of post-intravitreal injection endophthalmitis were identified (incidence rate of 0.0388%; 95% confidence interval, 0.0217%-0.0644%) or approximately 1 case for every 2578 intravitreal injections. Between 1 October 2014 and 31 October 2016, while topical antibiotic prophylaxis was used postoperatively, 14,828 intravitreal injections were performed and 5 cases of endophthalmitis were reported (0.0337%; 95% confidence interval, 0.0129%-0.0739%). Between 1 November 2016 and 30 November 2018, while no prophylaxis was used, 18,687 intravitreal injections were performed and 8 cases of endophthalmitis were identified (0.0428%; 95% confidence interval, 0.0202%-0.0808%). There were no statistical differences in the incidence rates between the two groups ( = 0.675).

CONCLUSION

The incidence rate of endophthalmitis in the group with topical antibiotic prophylaxis after intravitreal injection was similar to the group with no prophylaxis. Changing the current clinical practice to no antibiotic prophylaxis had no effect on the incidence of endophthalmitis.

摘要

目的

比较玻璃体腔内注射时使用和不使用局部抗生素预防的眼内炎发生率。

方法

这是一项单中心回顾性病例对照研究。纳入 2014 年 10 月 1 日至 2018 年 11 月 30 日期间因各种视网膜血管疾病接受雷珠单抗、贝伐单抗、阿柏西普或皮质类固醇玻璃体腔内注射治疗的所有患者。通过审查计费代码和实践管理记录确定患者总数和注射次数。通过计费记录确定眼内炎病例，然后通过图表审查进行确认。将 24 个月时玻璃体腔内注射后使用局部抗生素与 24 个月时不使用局部抗生素进行比较。

结果

2014 年 10 月 1 日至 2018 年 11 月 30 日期间，共进行了 33515 次玻璃体腔内注射，发现 13 例玻璃体腔内注射后眼内炎（发生率为 0.0388%；95%置信区间，0.0217%-0.0644%），即每 2578 次玻璃体腔内注射约发生 1 例。2014 年 10 月 1 日至 2016 年 10 月 31 日期间，术后使用局部抗生素预防时，共进行了 14828 次玻璃体腔内注射，报告了 5 例眼内炎（0.0337%；95%置信区间，0.0129%-0.0739%）。2016 年 11 月 1 日至 2018 年 11 月 30 日期间，未使用预防措施时，共进行了 18687 次玻璃体腔内注射，发现 8 例眼内炎（0.0428%；95%置信区间，0.0202%-0.0808%）。两组间的发生率无统计学差异（ = 0.675）。