Minimizing the risk of endophthalmitis following intravitreal injections

Over the last decade, the use of intravitreal injections has gained increasing popularity in the treatment of many intraocular disorders. Intravitreal injections have been employed to deliver antibiotics, antivirals, steroids, gas, and antivascular endothelial growth factor. The specific methods and techniques employed for intravitreal injections differ among various studies. We comment on the use of preoperative and postoperative antibiotics, type of anesthesia, gauge of the needle, and coordinates of injection. Intravitreal injections can give rise to complications, of which the most significant and devastating is endophthalmitis. We describe the factors affecting incidence of endophthalmitis after intravitreal injections, recommendations for prophylaxis, and outcomes following endophthalmitis. With increasing experience, the future will bring a reduction in the incidence of endophthalmitis, particularly as the use of intravitreal injections is increasingly supplemented by sustained release devices.