Ophthalmic Surg Lasers Imaging Retina. 2023 Sep;54(9):520-525. doi: 10.3928/23258160-20230808-01. Epub 2023 Aug 1.
The impact of anti-sepsis-anesthesia sequence in intravitreal injection (IVI)-associated endophthalmitis is unknown. We compared outcomes of patients who had 10% topical povidone-iodine before or after 2% topical lidocaine gel during IVIs.
A retrospective study of IVIs in nine clinical sites was undertaken. Group 1 had lidocaine gel applied first. This protocol was changed on March 1, 2020, with Group 2 having povidone-iodine applied first. Visual and micro-biological outcomes were compared.
Among 72 cases (0.07%) from 102,908 IVIs, Group 1 had 59 cases from 65,307 IVI (0.09%) and Group 2 had 13 cases from 37,601 IVI (0.03%; = 0.001). There was no significant difference in the best-corrected visual acuity between groups. Highly virulent bacteria were predominantly isolated in Group 1, but proportions of gram-positive bacterial growth were similar.
Application of povidone-iodine before lidocaine gel, compared to after, significantly decreased rate of IVI endophthalmitis, with no significant changes in visual and microbiological outcomes. .
抗脓毒症-麻醉顺序对玻璃体腔内注射（IVI）相关眼内炎的影响尚不清楚。我们比较了在进行 IVI 时，10%聚维酮碘滴眼液滴眼在前或在后的患者结局。
在九个临床地点进行了一项 IVI 的回顾性研究。第 1 组先使用利多卡因凝胶，该方案于 2020 年 3 月 1 日更改，第 2 组先使用聚维酮碘。比较了视力和微生物学结果。
在 102908 次 IVI 中的 72 例（0.07%）病例中，第 1 组 59 例（0.09%）来自 65307 次 IVI，第 2 组 13 例（0.03%）来自 37601 次 IVI（ = 0.001）。两组间最佳矫正视力无显著差异。第 1 组主要分离出高毒力细菌，但革兰氏阳性菌生长的比例相似。
与利多卡因凝胶后使用相比，在使用利多卡因凝胶前使用聚维酮碘显著降低了 IVI 眼内炎的发生率，而视力和微生物学结果无显著变化。
