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July 2013

Is the Use of Topical Antibiotics for Intravitreal Injections the Standard of Care or Are We Better Off Without Antibiotics?

Author Affiliations
  • 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • 2Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania
  • 3Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
JAMA Ophthalmol. 2013;131(7):840-842. doi:10.1001/jamaophthalmol.2013.2524

Intravitreal injection of medication is one of the most commonly performed medical procedures in the United States with well over 1 million injections performed annually.1 This number is likely to increase even further because of the aging population as well as the expanding number of indications for intravitreal injections. The most serious complication of intravitreal injection is infectious endophthalmitis, with a reported incidence of 0.02% to 0.1%.2,3 Many patients treated with intravitreal injections receive injections on a monthly basis. Thus, although the risk of endophthalmitis associated with a single injection may be 0.02% to 0.1%, an individual patient’s risk during an entire treatment series may be as high as 1%.4 Although outcomes of infectious endophthalmitis have improved significantly over the past few decades, visual loss can still be severe.5 It is, therefore, imperative that the optimal infection prophylaxis regimen is used with each treatment.

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