Abstract
BackgroundIntravitreal injection of medications is one of the most common procedures performed in ophthalmology. Intravitreal anti-VEGF agents are currently the chosen treatment for ocular fundus diseases, including age-related macular degeneration and diabetic retinopathy. As an invasive procedure it involves risks. The most serious complication from intravitreal injection of anti-VEGF agents is endophthalmitis (EO). Although rare, EO can result in devastating loss of vision. This article evaluates whether the use of an ultra-clean air flow (UA) can be another useful tool in the prevention of EOs. Accordingly, the maintenance of asepsis of the surgical field of intravitreal injections was verified with and without the use of UA.MethodsThe study was conducted in operating room of an ambulatory surgery center on four different surgical days when just intravitreal injections were scheduled. Two experiments using two Blood Agar and two Chocolate Agar plates (first 2 days; 4 plates by day) were carried out by positioning an UA directed to the surgical table and two other experiments (last 2 days; 4 plates per day) were carried out using similar plates without the use of the UA. All Blood Agar and four Chocolate Agar plates were positioned on the surgical table, close to the surgical filed. At the end of the day, after the conclusion of the intravitreous injections, the plates were sent for a biomolecular study that was carried out after 1 day of incubation at 37 °C.ResultsThe sixteen plates, eight Blood Agar and eight Chocolate Agar, were analyzed qualitatively for the growth or not of microorganism’s colonies and identification of their species. The biomolecular study demonstrated the growth of bacteria of the genus Micrococcus sp. with the use of the UA and without the the UA bacterias of the genera Bacillus sp, Staphylococcus haemolyticus, Staphylococcus aureus and Staphylococcus cohnii ssp urealyticus were found.ConclusionThe use of UA close to the operating table prevented the growth of pathogenic bacteria and should be considered as an alternative tool to avoid the contamination of materials and drugs used for intravitreal injections.
Highlights
Intravitreal injection of medications is one of the most common procedures performed in ophthalmology
The most usual ones are coagulase-negative staphylococci (CONS), most commonly Staphylococcus epidermidis followed by Streptococcus viridans, which is especially related to contamination of the operating room when there is frequent conversation during the IVIs procedures [7]
Staphylococcus aureus, Bacillus spss and Pseudomonas spss are important microorganisms to be considered in the etiology of EO [2, 8]
Summary
Intravitreal injection of medications is one of the most common procedures performed in ophthalmology. Intravitreal anti-VEGF agents are currently the chosen treatment for ocular fundus diseases, including age-related macular degeneration and diabetic retinopathy. The most serious complication from intravitreal injection of anti-VEGF agents is endophthalmitis (EO). The development of targeted molecular therapy to inhibit vascular endothelial growth factor (VEGF) has revolutionized the treatment and visual prognosis of retinal diseases such as diabetic retinopathy and age-related macular degeneration, as well as macular edema and retinal vein occlusion through performing intravitreal. The most serious complication from IVIs of anti-VEGF agents is endophthalmitis (EO). Despite the incidence of EO after anti-VEGF IVI is very low (0.038 to 0.065%) [3, 4], it may result in partial visual loss or even blindness [5, 6]. Staphylococcus aureus, Bacillus spss and Pseudomonas spss are important microorganisms to be considered in the etiology of EO [2, 8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
