Reduced Incidence of Intravitreal Injection-Related Endophthalmitis With Prefilled Syringes.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pharmacology

Background:

• Intravitreal injections of anti-VEGF medications are common for treating retinal diseases.
• Endophthalmitis is a serious complication following intravitreal injections.
• The preparation method of anti-VEGF medications may influence infection risk.

Purpose of the Study:

• To compare the incidence of endophthalmitis between anti-VEGF medications in prefilled syringes and non-prefilled preparations.
• To analyze the clinical characteristics and outcomes of injection-related endophthalmitis.

Main Methods:

• Retrospective chart review of intravitreal anti-VEGF injections administered between January 1, 2014, and December 31, 2019.
• Identification and analysis of eyes diagnosed with injection-related endophthalmitis.
• Comparison of endophthalmitis rates and microbiological findings based on medication type (prefilled vs. non-prefilled).

Main Results:

• A total of 325,990 injections were reviewed, with 88 cases of endophthalmitis.
• The endophthalmitis rate was lowest for ranibizumab prefilled syringe (RANPFS) at 0.0154%, compared to bevacizumab (0.0312%), ranibizumab (0.0226%), and aflibercept (0.0366%).
• RANPFS showed a significantly lower rate of culture-proven endophthalmitis (P = .003), and visual acuity outcomes were similar across groups.

Conclusions:

• Anti-VEGF medications in prefilled syringes may decrease the risk of medication contamination during preparation.
• Ranibizumab prefilled syringe (RANPFS) was associated with a lower incidence of injection-related endophthalmitis compared to non-prefilled anti-VEGF agents.
• Prefilled syringes represent a potentially safer option for intravitreal anti-VEGF administration.