Outcome of intravitreal bevacizumab injection without pre and postoperative antibiotics

Abstract

Backgound: Intravitreal injections are the most common treatment modality for several retinal pathologies. Despite endophthalmitis being the most feared complication, antibioprophylaxis remains controversial in intravitreal injections. Methods: This was a retrospective study done for a period of 2 years from 1st January 2017 to 31st December 2018 in B. P Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) among patients receiving intravitreal bevacizumab. The intravitreal injection was given by a single surgeon. It included 503 eyes which received intravitreal bevacizumab over a period of 2 years without pre and postoperative antibiotics. Results: Out of 503 eyes studied over a period of 2 years without antibiotic prophylaxis the rate of endophthalmitis was 0.0019% which is very low compared to the other studies with rate of endophthalmitis between 0.019-0.09%. Conclusion: The risk of endophthalmitis was low even without pre/post-operative antibiotics. Intravitreal injection can be given safely without pre-operative and post-operative antibiotics. Trial Registration not applicable as it is a retrospective study.

Use of Intravitreal Bevacizumab Injection among Patients Undergoing Surgical Retinal Interventions at Tertiary Eye Hospital: A Descriptive Cross-sectional Study

“…This similar gender disparity was also observed in other studies in Nepal. 5,9 Nepal is a male dominant country, and probably they tend to seek medical attention earlier than females. 11 The mean age of patients needing IVB varied according to the type of retinal problems.…”

Complications of intravitreal injections: 2022

“…The three most commonly used anti-VEGF medicines are bevacizumab, ranibizumab, and aflibercept. Rates of endophthalmitis are low with large retrospective studies reporting rates of 0.019–0.07% [3–5]. The rates of endophthalmitis among bevacizumab, ranibizumab, and aflibercept do not differ significantly [3,6].…”

“…Rates of endophthalmitis for intravitreal anti-VEGF injections range between 0.019% and 0.07%, and for intravitreal steroids and steroid implants generally range from 0.001% to 0.13% [3][4][5]. Much effort has been directed to reducing this rate, given the rise in the number of intravitreal injections administered.…”

Intravitreal Injection Therapy: Current Techniques and Supplemental Services

“…Preoperative antibiotics are not necessary or helpful in preventing ocular infection and may inadvertently promote resistant bacteria on the ocular surface. 27,28 Immobilizing the patient's head, eyelids, and eye is helpful in creating a controlled environment for intravitreal injection. This lowers the risk of endophthalmitis as well as various traumatic complications, including cataract, 29 RD, 11 and corneal abrasion.…”