Endophthalmitis associated with intravitreal injections: office-based setting and operating room setting

To report on the occurrence of endophthalmitis after intravitreal injections (IVI) in two different settings: office-based and operating room.

Consecutive case series. Retrospective review of all patients who underwent IVI by 2 physicians between January 2009 and December 2011. Group A underwent IVI in the examination room in office-based setting and Group B underwent IVI in the operating room.

A total of 11,710 IVIs were performed during the study period. Group A: A total of 8,647 IVIs performed including 2,041 ranibizumab, 6,169 bevacizumab, and 437 triamcinolone acetonide. The diagnosis included neovascular age-related macular degeneration (5,376), diabetic macular edema (1,587), retinal vein occlusion (1,068), and miscellaneous diagnosis (616). Group B: A total of 3,063 IVIs performed including 683 ranibizumab, 2,364 bevacizumab, and 16 triamcinolone acetonide. The diagnosis included neovascular age-related macular degeneration (1,836), diabetic macular edema (771), retinal vein occlusion (189), and miscellaneous diagnosis (267). A total of 5 cases (0.043%) of clinically suspected endophthalmitis occurred in 11,710 injections. Three cases (0.035%) occurred in Group A, and 2 cases (0.065%) occurred in Group B.

The rate of clinically suspected endophthalmitis after IVIs is low whether the procedure is performed in the office or operating room setting. The findings have implications in terms of the patient convenience, efficiency, and cost of administrating these treatments.