Intravitreal Injections and Face Masks: Endophthalmitis Risk Before and During the COVID-19 Pandemic

Purpose: To assess the added risk of acute endophthalmitis after intravitreal injections associated with the widespread use of face masks during the COVID-19 pandemic. Methods: In this retrospective, single-center study, records of patients with acute endophthalmitis following intravitreal bevacizumab (IVB) injections during the pre-COVID era-that is, March 1st, 2013 to October 31st, 2019 -and the COVID-19 era-that is, March 1st, 2020 to April 1st, 2021 -were reviewed and compared. Results: A total of 28,085 IVB injections were performed during the pre-COVID era; nine eyes of nine patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.032% (3.2 in 10,000 injections). In the COVID era, 10,717 IVB injections were performed; four eyes of four patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.037% (3.7 in 10,000 injections). The incidences of post-IVB endophthalmitis during these two eras were not statistically significantly different (P = 0.779). Conclusion: Face masking protocols seem unlikely to impose any additional risk of post-IVB endophthalmitis.

Automated summary

To assess the additional risk of acute endophthalmitis after intravitreal injections associated with face masks during the COVID-19 pandemic, a retrospective study was conducted comparing cases during the pre-COVID era (March 1st, 2013 to October 31st, 2019) and the COVID era (March 1st, 2020 to April 1st, 2021) of intravitreal bevacizumab (IVB) injections. The incidence of post-IVB endophthalmitis was compared between the two eras and found to be statistically similar, suggesting that the use of face masks does not increase the risk of post-IVB endophthalmitis.