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.


COVID-19; Endophthalmitis; Face Mask; Intravitreal Injection; Infection

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