Abstract

FR.13.14

Incidence of endophthalmitis after intravitreal Avastin injections with and without postoperative topical antibiotic application

Meyer C. H.^1,2, Mennel S.², Eter N.¹, Holz F. G.¹ (for the Avastin study group)
¹Department of Ophthalmology, University of Bonn, ²Department of Ophthalmology, Philipps-University Marburg

Objective: Intravitreal injection of vascular endothelial growth factor (VEGF)-inhibitors is a save approach under standardized procedure. We examined in a retrospective study the incidence of intraocular inflammations and endophthalmitis for out-patient and in-patient services.
Methods: Two Centers performed 1.067 intravitreal Avastin injections (IVA). The application was performed under aseptic conditions with a sterile drape lidspeculum and after an incubation of 5 Povidone Iodine for 60 seconds in the conjunctival fornix. Center A performed all applications as an outpatient procedure with no postoperative topical antibiotics. Center B performed all IVA prior to hospital admission of one day and an application of topical antibiotics for 3 days. In both centers the patients were told to return to the hospital immediately of unclear visual disturbance, pain or redness of the eyes was noticed.
Results: 556 IVA were applied on center A. Postoperatively there was no endophthalmitis, 2 patients developed on the 2. postoperative day a mild intraocular Uveitis, which was treated by local steroid ointments. Center B applied 511 IVA and noticed 5 days after demission from the hospital 2 presumed endophthalmitis cases, who received a vitrectomy when their vision dropped to counting fingers. There was no positive microbiological result of both vitreous probes.
Conclusions: Although equal treatment guidelines were established, the perioperative hospital admission and postoperative application of topical antibiotic ointments could not reduce the events of mild and severe intraocular endophthalmitis cases.

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