Purpose: To review techniques that are important in preventing endophthalmitis following intravitreous injections based on the available evidence Methods: A review of the literature regarding existing evidence that is relevant to post-injection endophthalmitis prophylaxis Results: The available evidence regarding endophthalmitis prophylaxis is largely based on intraocular surgery, particularly cataract surgery Despite the controversy and the paucity of evidence regarding endophthalmitis prophylaxis for intravitreous injections, it is recommended that povidone-iodine should be used prior to intravitreous injections to minimize or eliminate the presence of ocular surface bacteria Administration of topical antibiotics may also be considered before and after the intravitreous injections Strict adherence to aseptic techniques, including the use of an eyelide speculum is also important Conclusion: Endophthalmitic can occur following intravitreous injections Prophylaxis with topical povidone-iodine, and possibly antibiotics, as well as adherence to aseptic technique may minimize the risk of post-injection endophthalmitis

Minimizing the risk of endophthalmitis following intravitreous injections.

Three-day application of topical ofloxacin reduces the contamination rate of microsurgical knives in cataract surgery: a prospective randomized study.

Bacteriology and cefuroxime resistance in endophthalmitis following cataract surgery before and after the introduction of prophylactic intracameral cefuroxime: a retrospective single-centre study.

The challenge of determining aqueous contamination rate in anterior segment intraocular surgery

According to the most recently reported study, the incidences of postcataract extraction endophthalmitis (PCE) range from 0.06% to 0.29%. A retrospective study performed at the Massachusetts Eye and Ear Infirmary showed the overall rate of PCE from October 1994 to July 2005 to be 0.15% (65/43,356). The relatively low incidence of PCE renders it difficult to conduct a well-designed prospective study and identify the risk factor clearly. The most common bacteria causing PCE are presumably derived from patients’ conjunctiva or eyelids. The organisms isolated from the vitreous of PCE patients were genetically the same as the bacteria isolated from the conjunctiva, eyelids, or nose in 82% (14/17) of cases. In the Endophthalmitis Vitrectomy Study, 68% (71/105) of coagulasenegative Staphylococci obtained from the vitreous or anterior chamber of postoperative endophthalmitis (POE) patients were genetically identical to the bacteria isolated from their eyelids. In another Endophthalmitis Vitrectomy Study series, 69.3% (291/420) of patients had confirmed microbiologic growth of their aqueous or vitreous samples. The most common bacteria isolated were Gram-positive coagulase-negative micrococci (consists of coagulase-negative staphylococci, predominantly Staphylococcus epidermidis, plus an isolate of Micrococcus kristinae (70%), Staphylococcus aureus (10%), and streptococcal species (9%). These 2 studies were criticized, however, because bacteria were retroactively

Perioperative prophylaxis for postcataract extraction endophthalmitis.

PURPOSE. To compare cataract surgery contamination rates in large-incision extracapsular cataract extraction (ECCE) and phacoemulsification (PE), we studied 65 cases prospectively. METHODS. Thirty-five cases were operated by large-incision ECCE (Group I) and 30 by PE (Group II). Conjunctival swab cultures were taken immediately before surgery and anterior chamber aspirate was taken for culture upon completion of surgery for each case. RESULTS. Anterior chamber cultures were positive in 22.8% of the cases in group I and 23% in Group II. Frequencies of contamination in each group were no different (x 2 : 0. 22, p>0.05). When the contaminations were evaluated in relation to operating time, prolongation of the operating time raised the contamination rate in Group I (p 0. 05). Silicone and PMMA intraocular lenses (IOL) were tested to see whether they had any additional risk of contamination. The frequencies of contaminated silicone IOL implanted cases (6/26) and contaminated PMMA IOL implanted cases (8/39) were similar (x 2 : 0.36, p>0.05). CONCLUSIONS. Although the architecture of the incision and irrigation dynamics provided an advantage to the PE technique as the operating time became longer, routine PE was not superior to classical ECCE with respect to contamination when performed in the same circumstances. Prolonging the operating time raised the contamination rate in classical ECCE.

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Does surgical technique influence cataract surgery contamination

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Does surgical technique influence cataract surgery contamination