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. 2023 Jan;261(1):97-102.
doi: 10.1007/s00417-022-05768-6. Epub 2022 Aug 6.

Legal obligation in the general population: face mask influence on endophthalmitis after intravitreal injection

Jonas Neubauer  1 , Konstantinos Gklavas  2 , Friederike Kortüm  2 , Mariya Gosheva  2 , Karl Ulrich Bartz-Schmidt  2 , Focke Ziemssen  2   3
Affiliations

Legal obligation in the general population: face mask influence on endophthalmitis after intravitreal injection

Jonas Neubauer et al. Graefes Arch Clin Exp Ophthalmol. 2023 Jan.

Abstract

Purpose: To investigate whether compulsory face masking in public life changes the incidence or pattern of post-injection endophthalmitis (PIE).

Patients and methods: All injections of bevacizumab, ranibizumab, aflibercept, dexamethasone or triamcinolone between 01/01/2015 and 12/31/2021 at the University Eye Clinic of Tuebingen were included in this retrospective analysis. The injection procedure itself was unchanged since 2015 and included the use of a sterile drape covering the head up to the shoulders which prevents airflow toward the eye. Furthermore, all staff wore a face mask and gloves at all times. The two study periods were defined by the introduction of a compulsory face masking rule in public life (01/01/2015 until 04/27/2020 vs. 04/28/2020 until 12/31/2021).

Results: A total of 83,543 injections were performed in the tertiary eye clinic, associated with a total of 20 PIE (0.024%, 1/4177 injections). Of these, thirteen PIE were documented during the pre-pandemic period (0.021%, 1/4773 injections) and seven PIE during the pandemic period (0.033%, 1/3071 injections). No significant difference in PIE risk was observed (p = 0.49), and there was no case of oral flora associated PIE.

Conclusion: Although some potential confounders (wearing time, skin flora) could not be considered, there was no clear signal that the introduction of compulsory face masking in public life did alter the risk for PIE in our patient population. Three and six months after PIE, no difference in visual acuity was detectable between the two study periods.

Keywords: Bacteria; Covid-19; Endophthalmitis; Face mask; Intravitreal injection; Post-injection endophthalmitis.

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Conflict of interest statement

F. Z.: Consultant: Alimera Sciences, Allergan/Abbvie, Bayer, Boehringer-Ingelheim, Novartis, NovoNordisk, MSD, Oxurion, Roche/Genentech; Speaker: Alimera, Allergan/Abbvie, Bayer, BDI, CME Health, Gerling, Novartis, ODOS, Roche, Research: Bayer, BMBF, Clearside, DFG, Kodiak, Iveric, Ophtea, Novartis, Regeneron. All other authors declare they have no financial or direct/indirect competing interest.

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