Wills Eye Hospital, Philadelphia, Pennsylvania.
VitreoRetinal Surgery, P.L.L.C., Minneapolis, Minnesota.
Ophthalmology. 2021 Nov;128(11):1620-1626. doi: 10.1016/j.ophtha.2021.05.010. Epub 2021 May 18.
Routine use of face masks for patients and physicians during intravitreal anti-vascular endothelial growth factor (VEGF) injections has increased with the emergence of the coronavirus disease 2019 pandemic. This study evaluates the impact of universal face mask use on rates and outcomes of post-injection endophthalmitis (PIE).
Retrospective, multicenter, comparative cohort study.
Eyes receiving intravitreal anti-VEGF injections from October 1, 2019, to July 31, 2020, at 12 centers.
Cases were divided into a "no face mask" group if no face masks were worn by the physician or patient during intravitreal injections or a "universal face mask" group if face masks were worn by the physician, ancillary staff, and patient during intravitreal injections.
Rate of endophthalmitis, microbial spectrum, and visual acuity (VA).
Of 505 968 intravitreal injections administered in 110 547 eyes, 85 of 294 514 (0.0289%; 1 in 3464 injections) cases of presumed endophthalmitis occurred in the "no face mask" group, and 45 of 211 454 (0.0213%; 1 in 4699) cases occurred in the "universal face mask" group (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.51-1.18; P = 0.097). In the "no face mask" group, there were 27 cases (0.0092%; 1 in 10 908 injections) of culture-positive endophthalmitis compared with 9 cases (0.004%; 1 in 23 494) in the "universal face mask" group (OR, 0.46; 95% CI, 0.22-0.99; P = 0.041). Three cases of oral flora-associated endophthalmitis occurred in the "no face mask" group (0.001%; 1 in 98 171 injections) compared with 1 (0.0005%; 1 in 211 454) in the "universal face mask" group (P = 0.645). Patients presented a mean (range) 4.9 (1-30) days after the causative injection, and mean logarithm of the minimum angle of resolution (logMAR) VA at endophthalmitis presentation was 2.04 (20/2200) for "no face mask" group compared with 1.65 (20/900) for the "universal face mask" group (P = 0.022), although no difference was observed 3 months after treatment (P = 0.764).
In a large, multicenter, retrospective study, physician and patient face mask use during intravitreal anti-VEGF injections did not alter the risk of presumed acute-onset bacterial endophthalmitis, but there was a reduced rate of culture-positive endophthalmitis. Three months after presentation, there was no difference in VA between the groups.
随着 2019 年冠状病毒病大流行的出现，在接受抗血管内皮生长因子（VEGF）玻璃体腔内注射期间，患者和医生常规使用口罩。本研究评估了普遍使用口罩对注射后眼内炎（PIE）发生率和结局的影响。
回顾性、多中心、对照队列研究。
2019 年 10 月 1 日至 2020 年 7 月 31 日期间，在 12 个中心接受抗 VEGF 玻璃体腔内注射的眼睛。
如果在玻璃体腔内注射期间医生或患者不戴口罩，则将病例分为“无口罩”组；如果医生、辅助人员和患者在玻璃体腔内注射期间戴口罩，则将病例分为“通用口罩”组。
眼内炎发生率、微生物谱和视力（VA）。
在 505 968 次玻璃体腔内注射中，110 547 只眼中有 85 例（0.0289%；1/3464 次注射）疑似眼内炎，“无口罩”组发生 27 例（0.0092%；1/10908 次注射）培养阳性眼内炎，“通用口罩”组发生 45 例（0.0213%；1/211454 次注射）（比值比[OR]，0.74；95%置信区间[CI]，0.51-1.18；P=0.097）。“无口罩”组中有 3 例（0.001%；1/98171 次注射）口腔菌群相关眼内炎，而“通用口罩”组中仅有 1 例（0.0005%；1/211454 次注射）（P=0.645）。“无口罩”组患者在致病注射后平均（范围）4.9（1-30）天出现症状，“无口罩”组眼内炎发病时的最小分辨角对数视力（logMAR）均值为 2.04（20/2200），“通用口罩”组为 1.65（20/900）（P=0.022），但治疗后 3 个月时无差异（P=0.764）。
在一项大型、多中心、回顾性研究中，在抗 VEGF 玻璃体腔内注射期间，医生和患者戴口罩并未改变疑似急性细菌性眼内炎的风险，但培养阳性眼内炎的发生率降低。发病后 3 个月时，两组间 VA 无差异。
