Rates of endophthalmitis before and after transition from povidone-iodine to aqueous chlorhexidine asepsis for intravitreal injection.

Autor: Stephenson KA; Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC. Electronic address: kirkstephenson@hotmail.com., Merkur A; Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC., Kirker A; Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC., Albiani D; Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC., Pakzad-Vaezi K; Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC.
Jazyk: angličtina
Zdroj: Canadian journal of ophthalmology. Journal canadien d'ophtalmologie [Can J Ophthalmol] 2024 Dec; Vol. 59 (6), pp. 424-429. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1016/j.jcjo.2024.01.012
Abstrakt: Objective: To assess the rate of post-intravitreal injection endophthalmitis between 2 asepsis groups: aqueous chlorhexidine 0.1% and povidone-iodine 5%.
Design: Retrospective, observational cohort study.
Participants: Patients with infectious endophthalmitis post intravitreal injection (n = 58) at a single centre from July 2009 to July 2022.
Methods: Retrospective chart review of all patients receiving intravitreal injections (216 593 injections) at a single centre over 14 years. Patients from July 2009 to February 2017 received povidone-iodine 5%, and patients from March 2017 to July 2022 received aqueous chlorhexidine 0.1%. Assessed characteristics of endophthalmitis cases included demographics, visual function, intervention type, and microbiological results.
Results: The rate of endophthalmitis was comparable for povidone-iodine (1.4:5000) and aqueous chlorhexidine (1.3:5000) (p = 0.77). Vitreous cultures were negative for 55% of patients. Visual acuity (VA) outcomes did not differ between asepsis groups nor between culture positive/negative groups. Patients having vitrectomy (PPV) had worse final vision (p = 0.08) but there was no VA difference between early and late PPV.
Conclusions: Aqueous chlorhexidine 0.1% is a viable and safe alternative to povidone-iodine 5% for post-intravitreal injection endophthalmitis prophylaxis and may reduce ocular surface adverse events and discomfort.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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