Intravitreal injections primary prevention: a case-control study

OBJECTIVE: Intravitreal injec tions (IVI) of therapeutic substances are one of the most common procedures in ophthalmol ogy and, for sure, the most feared complica tion of them is endophthalmitis. Nowadays, a precise prophylactic protocol does not exist to avoid these infections, and the role of new anti septic drops is an interesting field of research in this regard. In this article we are going to dis cuss the tolerability and the efficacy of a new antiseptic drop based on a solution of hexam idine diisethionate 0.05% (Keratosept®; Brus chettini Srl, Genoa, Italy). PATIENTS AND METHODS: This was a sin gle-center, case-control study, comparing the in vivo effect of hexamidine diisethionate 0.05% with povidone iodine 0.6% solution during IVI program. Ocular bacterial flora composition was analyzed with a conjunctival swab on day 0. After injection patients underwent antibac terial prophylaxis with Keratosept for 3 days or povidone iodine 0.6%. A second conjunctival swab was collected on day 4 and patients were asked to fulfill a questionnaire based on the OS Di model, to investigate the ocular tolerability of the drug administered. RESULTS: Efficacy was tested on 50 patients, 25 of whom received hexamidine diisethionate 0.05% drops and the other 25 received povidone iodine 0.6% solution drops, 100 total conjuncti val swabs, 18 positive swabs before and 9 after treatment for the first group and 13 before and 5 after for the second one. Tolerability was tested on 104 patients, 55 underwent Keratosept thera py and 49 povidone iodine one. CONCLUSIONS: Keratosept demonstrated a good efficacy profile with better tolerability against povidone iodine in the analyzed sample.