Abstract:
Purpose: To assess the efficacy of per-operative 5% Povidone-iodine alone or in combination with post injection topical antibiotics for reducing vitreous activity in patients undergoing Intravitreal injection of anti-vascular endothelial growth factors Bevacizumab.
Methods: Total of 114 enrolled patients with retinal medical pathologies requiring Intravitreal anti vascular growth factors were randomized to study group A (5% Povidone-iodine per operative on conjunctiva for 3 minutes) and group B (5% Povidone-iodine per-operative on conjunctiva for 3 minutes and post injection topical antibiotics fluroquinolone four times a day for a week) with 57 patients in each group. All Intravitreal injections were performed in operating room in a sterile manner. Vitreous activity assessed using Sun's classification on slit lamp on first day and day 7 post Intravitreal injection of 1.25mg/0.05ml anti VEGF Bevacizumab. Collected data of group A and B was analyzed.
Result: Out of 114 patients, 75 were males and 39 were females. Vitreous activity seen at day one post injection was same in both study groups while at day seven group A had increased vitreous cellular activity as compared to study group B. Both day one and day seven activity within the study groups were insignificant with p=0.244 and p=0.498 respectively.
Conclusions: In both groups A and B, 5% Povidone-iodine (PI) solution shows effective prophylaxis against Endophthalmitis in Intravitreal anti VEGF injections. Post injection topical antibiotics should be avoided following Intravitreal injections of anti VEGF as it can increase microorganism resistance, virulence and add additional cost for the patients.