Effect of lidocaine gel anesthesia on endophthalmitis rates following intravitreal injection

Ophthalmic Surg Lasers Imaging. 2012 Mar-Apr;43(2):115-20. doi: 10.3928/15428877-20120119-01. Epub 2012 Jan 26.

Abstract

Background and objective: To determine whether the use of lidocaine gel before application of povidone-iodine affects endophthalmitis rates following intravitreal injections.

Patients and methods: Retrospective consecutive case series of all intravitreal injections and post-intravitreal injection endophthalmitis cases at one institution from 2000 to 2009. A review of medical records of post-intravitreal injection endophthalmitis cases was performed to determine whether lidocaine gel was applied prior to povidone-iodine antisepsis and to analyze the clinical course and outcomes.

Results: A total of 8,802 intravitreal injections were administered during the study period. When no lidocaine gel was used prior to povidone-iodine antisepsis, four cases of endophthalmitis following 4,120 intravitreal injections (0.097%) were recorded. When 2% lidocaine gel was applied before povidone-iodine, four cases of endophthalmitis following 4,682 intravitreal injections (0.085%) were observed (P = 1.00, odds ratio = 1.12).

Conclusion: The use of lidocaine gel prior to povidone-iodine antisepsis did not significantly alter post-intravitreal injection endophthalmitis rates.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage*
  • Anti-Infective Agents, Local / administration & dosage
  • Endophthalmitis / prevention & control*
  • Female
  • Follow-Up Studies
  • Gels
  • Humans
  • Intravitreal Injections / adverse effects*
  • Lidocaine / administration & dosage*
  • Male
  • Odds Ratio
  • Povidone-Iodine / administration & dosage
  • Retrospective Studies

Substances

  • Anesthetics, Local
  • Anti-Infective Agents, Local
  • Gels
  • Povidone-Iodine
  • Lidocaine