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—We appreciate Dr Fletcher's comments on our article. We share his interest in sterility in surgical procedures. Our basic concern is that we not introduce bacteria into the eye at the time of fluid-gas exchange. For that reason, we use gas, usually sterile air as indicated in the article, which has been passed through a polymer filter (Millipore) while being aspirated into the sterile syringe. We take extreme care to make sure that the needle is sterile when passing it into the eye and even think that once removed from the eye, the needle should be replaced if any repeated injection is required.As we indicated, we use topical antibiotic therapy such as gentamicin sulfate drops to the cornea and conjunctiva prior to gas injection. Recently, we began to add a topical povidone-iodine (Betadine) 10% solution, drop as well.We share Dr Fletcher's concern with sterile technique.
Landers MB, Robinson D, Olsen KR, Rinkoff J. Office Procedures Following Vitreoretinal Surgery-Reply. Arch Ophthalmol. 1985;103(11):1633. doi:10.1001/archopht.1985.01050110025009