Endophthalmitis rates following alcohol-based chlorhexidine and povidone-iodine antisepsis for intravitreal injections
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Authors: C. Maya Tong, Marvi K. Cheema, Uriel Rubin, Bo Bao, Samir Nazarali, Steven R. J. Lapere, Rizwan Somani, Matthew T. S. Tennant
Author Disclosure Block: C. Tong: None. M.K.
Cheema: None. U. Rubin: None. B. Bao: None. S.
Nazarali: None. S.R.J. Lapere: None. R.
Somani: None. M.T.S. Tennant: None.
Abstract Body:
Purpose: Intravitreal injections (IVI) are the most frequently performed intraocular procedure in Canada. Povidone-iodine is the current gold standard for antisepsis for IVI and is widely used; chlorhexidine is a possible alternative antiseptic agent that has been shown to be equally effective. This study aims to compare our centre’s rate of endophthalmitis after IVI with 0.05% chlorhexidine with 4% alcohol base antisepsis to the rate of endophthalmitis after IVI with povidone-iodine antisepsis.Study Design: Retrospective cohort study
Methods: A retrospective electronic and paper chart review
was conducted for all patients who received 0.05% CH in 4% alcohol antisepsis
or PI for intravitreal injections at a group retina practice.
Results: 6445 IVI were performed using CH antisepsis, and 204 151
IVI were performed using PI antisepsis. Among the IVI patients that received CH
antisepsis, there were 3 cases of endophthalmitis (0.047%). Among IVIs that
received PI antisepsis, there were 35 cases of endophthalmitis (0.017%). There
was no statistically significant difference in rates of endophthalmitis between
the two groups (p = 0.084).
Conclusions: Alcohol based CH is non-inferior to using PI as
antisepsis for IVI. It offers similar levels of protection from endophthalmitis
and may be considered as a better tolerated alternative to PI.
