Bates Brandon, Fitzpatrick John, Rosanky Caroline, Moon Jared, Wood Edward, Storey Philip
Austin Retina Associates, Dell Medical School at The University of Texas at Austin, Austin, Texas.
Austin Retina Associates, Dell Medical School at The University of Texas at Austin, Austin, Texas.
Ophthalmol Retina. 2025 Mar 28. doi: 10.1016/j.oret.2025.03.022.
To evaluate the incidence of postinjection endophthalmitis (PIE) after intravitreal injection (IVI) of anti-VEGF agents in eyes prepared with topical 5% povidone-iodine (PI) or 0.05% aqueous chlorhexidine (AqCHX) as antisepsis.
Retrospective, single-center, comparative cohort study.
Individuals who received ≥1 intravitreal anti-VEGF injection with use of PI or AqCHX as antisepsis.
For all patients receiving intravitreal anti-VEGF injections at Austin Retina Associates between March 1, 2015 and November 1, 2023, all injections and cases of suspected PIE were identified with billing codes and confirmed with review of electronic medical record data. Eyes that presented after injection with pain or decreased vision warranting treatment with intravitreal antibiotics were considered suspected PIE cases. Eyes were grouped based on preparation with PI or AqCHX.
The primary outcomes were incidence of suspected and culture-positive PIE and visual acuity (VA) at 3 months postendophthalmitis.
A total of 302 474 IVIs were administered during the study period. Within the PI group, 59 cases of suspected PIE occurred after 267 190 injections (0.022%; 1 in 4529 injections) compared with 5 cases after 35 284 injections (0.014%; 1 in 7057 injections) in the AqCHX group (P = 0.34). For the PI group, there were 10 culture-positive PIE cases (0.0037%, 1 in 26 719 injections) compared with 0 cases in the AqCHX group (P = 0.25). At 3 months postinfection, average VA in the PI group was 0.97 (∼20/200) and 1.4 (∼20/500) in the AqCHX group (P = 0.41). When controlling for prefilled syringe status, there was no difference in rates of PIE between antisepsis groups (P = 0.23).
The incidence of endophthalmitis after IVI is low, with no difference in the rates of infection with eyes prepared with topical PI compared with AqCHX. Topical AqCHX has similar efficacy to PI for the prevention of endophthalmitis after IVI.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估在使用局部5%聚维酮碘（PI）或0.05%洗必泰水溶液（AqCHX）作为防腐剂制备的眼中，玻璃体内注射（IVI）抗VEGF药物后注射后眼内炎（PIE）的发生率。
回顾性、单中心、比较队列研究。
接受≥1次使用PI或AqCHX作为防腐剂的玻璃体内抗VEGF注射的个体。
对于2015年3月1日至2023年11月1日期间在奥斯汀视网膜协会接受玻璃体内抗VEGF注射的所有患者，通过计费代码识别所有注射及疑似PIE病例，并通过电子病历数据审查进行确认。注射后出现疼痛或视力下降且需要玻璃体内注射抗生素治疗的眼被视为疑似PIE病例。根据使用PI或AqCHX的制备情况对眼进行分组。
主要结局为疑似和培养阳性PIE的发生率以及眼内炎发生后3个月时的视力（VA）。
研究期间共进行了302474次IVI。在PI组中，267190次注射后发生了59例疑似PIE（0.022%；每4529次注射中有1例），而在AqCHX组中，35284次注射后发生了5例（0.014%；每7057次注射中有1例）（P = 0.34）。对于PI组，有10例培养阳性PIE病例（0.0037%，每26719次注射中有1例），而AqCHX组为0例（P = 0.25）。感染后3个月时，PI组的平均VA为0.97（约20/200），AqCHX组为1.4（约20/500）（P = 0.41）。在控制预填充注射器状态后，防腐剂组之间的PIE发生率无差异（P = 0.23）。
IVI后眼内炎的发生率较低，与使用AqCHX制备的眼相比，使用局部PI制备的眼的感染率无差异。局部AqCHX在预防IVI后眼内炎方面与PI具有相似的疗效。
在本文末尾的脚注和披露中可能会找到专有或商业披露信息。
