TITLE:
The Role of Prophylactic Antibiotic Use in Prevention of Endophthalmitis Following Intravitreal Injection of Anti-Vascular Endothelial Growth Factor Agents: A Meta-Analysis
AUTHORS:
Sonia B. Dhoot, Nancy Kunjukunju, Nelson Sabates
KEYWORDS:
Endophthalmitis; Intravitreal Injections; Anti-VEGF
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.3 No.2,
May
14,
2013
ABSTRACT: Purpose: To determine the role of
prophylactic antibiotic use in preventing endophthalmitis following
intravitreal injections of Anti-Vascular
Endothelial Growth Factor Agents (anti-VEGF).Methods: A meta-analysis was conducted
for studies reporting the rates of endophthalmitis following injection of
anti-vascular endothelial growth factor agents for a variety of disorders. Inclusion
criteria included reporting how many patients were given post-injection
antibiotic drops, and how many patients were diagnosed with endophthalmitis (both
with and without antibiotic drops). Results: The reported rate of endophthalmitis following intravitreal anti-VEGF
agents has varied significantly based on the study, with a range between
0.009% to 0.87%. In our meta-analysis, the rate of endophthalmitis in patients
receiving post-injection antibiotics was found
to be 0.081%, compared to 0.072% for patients who did not receive antibiotics. This
difference was not found to be statistically significant. Conclusion: Although
the rate of endophthalmitis is extremely low following intravitreal anti-VEGF
injections, the controversy regarding the best prevention of this dreaded complication continues. According to our meta-analysis, the
answer does not seem to lie in post-injection antibiotic use.