Ocular Surface Bacterial Load in Intravitreal Injections: Lid Speculum vs. Manually Assisted Retraction

Özet

Purpose: To compare the microbiological outcome of an alternative technique for intravitreal injections with the conventional method.Materials and Methods: This is a cross sectional, prospective, case-control study. Patients undergoing intravitreal injections for retinaldiseases were randomized in two groups; in Group A, the eyelids were opened with a lid speculum and in Group B, the eyelids were retractedwith manual assistance. Following sample collection for microbiological evaluation, the procedure was completed in the conventional route inboth groups. The groups were compared by means of demographics, diagnosis, laterality and microbiological outcome.Results: There were 30 patients in each group. The patients had either neovascular age related macular degeneration or diabetic macular edema.The agent administered was either afl ibercept or ranibizumab. The mean age was 65.9 ± 10.6 and the male/female ratio was 32/28. There wasno signifi cant difference in age, gender, diagnosis, laterality or the agent administered between groups. The manual retraction technique wasassociated with less culture positive cases compared to speculum (19 vs. 22, p=0.580). The culture positivity rate was signifi cantly higher inmale patients (p=0.028). No endophthalmitis or ocular adverse events were encountered.Conclusion: Manual-assisted eyelid retraction for intravitreal injections offers improved microbiological outcome.