Endophthalmitis after resident-performed intravitreal bevacizumab injection

Abstract

Objective: To evaluate the rate of acute endophthalmitis after resident-performed intravitreal bevacizumab (IVB) injections and to compare the results with those performed by attending retina surgeons.

Design: Retrospective comparative case series.

Participants: Eight thousand thirty-seven patients treated with intravitreal injection of bevacizumab.

Methods: A retrospective chart review of the resident-performed IVB injections at Rassoul Akram Hospital and attending-performed IVB injections at a private eye clinic between 2011 and 2014 was undertaken. Cases of clinical endophthalmitis were identified.

Results: During the study interval, the overall incidence rate of postinjection endophthalmitis was 0.01% (1/8037). Antibiotic eye drops were prescribed after IVB injection for 2771 eyes (34.5%). The single case of acute endophthalmitis occurred after a resident-performed injection, and vitreous culture showed growth of Staphylococcus epidermidis. The incidence rate of acute endophthalmitis after resident-performed IVB injection was 0.02% (1/4921). No statistically significant difference was found in the rates of endophthalmitis between resident-performed and attending-performed injections (p = 1). Also, the difference in the rates of endophthalmitis between those receiving postinjection antibiotics and those who did not was not statistically significant (p = 0.3).

Conclusions: The risk for endophthalmitis after resident-performed IVB injection is low and similar to that of the supervising surgeons performing the procedure.