March 10, 2014
1 min read

No-talking policy during intravitreal injections associated with fewer cases of endophthalmitis

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PHILADELPHIA — A no-talking policy during intravitreal anti-VEGF injections appears to lower the risk of post-injection endophthalmitis, a speaker said here.

In a 2-year retrospective comparative case series, fewer cases of both culture-positive and oral flora-associated endophthalmitis were identified in the no-talking group compared with a group that was allowed to talk during the procedure, Michael L. Dollin, MD, said at the Wills Eye Annual Conference.

“Implementation of a no-talking policy during intravitreal injections appears to be effective in a real-world setting in helping further reduce the risk of post-injection endophthalmitis, including oral flora-associated cases,” Dollin said. “This is consistent with the idea that if you’re minimizing speech, you’re minimizing dispersal of respiratory droplets and therefore minimizing contamination of conjunctiva.”

Researchers reviewed billing records of patients who received anti-VEGF intravitreal injections between Jan. 1, 2009, and Dec. 31, 2012, as well as the endophthalmitis surveillance log, and compared the cases of endophthalmitis in the no-talking group with the talking group. In the group in which talking was permitted, 27 cases of endophthalmitis were reported out of 48,000 injections; nine were culture positive. In the no-talking group, 20 cases of endophthalmitis were reported out of 79,000 injections, and eight were culture positive.

“Attributing this reduction to the no-talking policy only makes sense if we see a reduction in oral flora-associated cases,” Dollin said.

The no-talking policy included no talking during the preparation of the injection or during the procedure.

Disclosure: Dollin has no relevant financial disclosures.