Masking for Eye Injections May Have Unintended Consequence

TOPLINE:

Masking during intravitreal anti-VEGF injections was associated with a similar incidence of endophthalmitis compared to not masking, in a large retrospective study. After adjusting for the use of prefilled syringes, however, masking was associated with higher odds of developing the inflammatory eye condition, according to research presented at the 2024 annual meeting of the American Academy of Ophthalmology (AAO).

METHODOLOGY:

• Researchers conducted a retrospective study of more than 1.04 million injections administered to 74,834 patients at five centers from January 2015 to September 2023 (mean age, 75.8 years).
• Injections were divided into a “No Face Mask” group and a “Face Mask” group if patients, providers, and ancillary staff wore masks during the procedure.
• The primary outcome was the incidence of endophthalmitis. The researchers also examined the use of prefilled syringes and culture results.
• Participating centers included Wills Eye Hospital in Philadelphia, Pennsylvania; NJ Retina, New Jersey; VitreoRetinal Surgery, Minneapolis; Austin Retina Associates, Austin, Texas; and New York University, New York City.

TAKEAWAY:

• The incidence of endophthalmitis was the same for the “Face Mask” and “No Face Mask” groups, at 0.017% in each (75 and 99 cases, respectively).
• The rate of positive cultures was similar for each group.
• In a multivariable model, masking was associated with higher odds of developing endophthalmitis (odds ratio, 1.5; P = .02).

IN PRACTICE:

“Although the mechanism remains unclear, a proposed mechanism includes bacterial dispersion toward the eyes with masking,” the researchers wrote.

SOURCE:

Sandy Samuel, MD, with Wills Eye Hospital, led the study, which was presented in a poster at AAO 2024 (October 18-21).

LIMITATIONS:

The researchers were limited in their ability to assess how strictly sites had adhered to their masking policies. The protocol for intravitreal injections was not standardized across institutions.

DISCLOSURES:

The study authors had no financial disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.