Retrospective review of the annual endophthalmitis rates following intravitreal injections at Royal Bournemouth Hospital over an eight‐year period from 01/02/2016 until 31/01/2024

Aims/Purpose: To present the annual rates of post‐intravitreal injection endophthalmitis at Royal Bournemouth Hospital (RBH) over an eight‐year period from 01/02/2016 until 31/01/2024.

Methods: The total number of intravitreal injections performed was identified retrospectively from our electronic records. The cases of post‐injection endophthalmitis were identified from the department's written logbook record.

Results: Over the above 8‐year‐period, a total number of 13 cases of endophthalmitis were identified. The total number of injections performed over this 8‐year‐period was 54,134. The annual endophthalmitis rates fluctuated from a minimum 0% (year 01/02/2016 until 31/01/20217) to a maximum of 0.05% (year 01/02/2019 until 31/01/2020). Mean annual endophthalmitis rate over this 8‐year‐period was 0.025%. 1 case occurred after an intravitreal Ozurdex injection and 12 following anti‐VEGF injections.

Conclusions: Despite the increasing number of injections every year, we noted that our endophthalmitis rates were consistently much lower than the estimated rate of 1 in 1000 (0.1%) in the literature. We postulate that our current standard local protocols and practices which include the use of sterile gloves, sterile drapes, face masks and pre‐injection instillation of povidone iodine in the fornix have played a pivotal role in keeping the annual endophthalmitis rates very low. Furthermore, the introduction of novel agents of biosimilars to Ranibizumab (Ongavia) and Faricimab (Vabysmo) which are withdrawn from vials and are not available in pre‐filled syringes did not have any adverse impact on our endophthalmitis rates. In 2014, the administration of chloramphenicol 0.5% antibiotic eye drops post‐intravitreal injections were stopped permanently. In 2016, specialist nurse injectors were introduced in our clinical practice. Based on our endophthalmitis rates over this 8‐year‐period, these two important changes in the clinical practice do not seem to have had a negative impact in our annual endophthalmitis rates. Our aim is to continue auditing our rates annually in order to ensure that we are a safe to practice macular unit and to maintain high quality patient care.