Intravitreal injections: antibiotics or antiseptics?

The treatment of age-related macular degeneration (AMD) with VEGF inhibitors presupposes multiple intravitreal injections (IVI), which requires safety measures and prevention of complications. Purpose: to compare the efficiency of the antibiotic moxifloxacin andthe antiseptic miramistinin the prevention of infectious complications of multiple IVIsof VEGF inhibitor Ranimizumab in AMD patients. Material and methods. 290 patients with wet AMD aged 69.2 ± 3.5 years were followed for 1 year. To prevent infections, group 1 consisting of 154 patients received instillations of 0.5 % solution of moxifloxacin 2 days prior to surgery, while group 2 (136 patients) received 0.01 % solution of miramistin. All instillations lasted one week after the IVI procedure. Results. A comparative analysis of the two groups of wet AMD patients respectively treated with moxifloxacin and miramistin revealed no inflammatory complications of multiple ranimizumab IVIs. It was demonstrated that the aseptic condition (interventionsperformed in a sterile operating room) and the antiseptic condition (use of povidone-iodine) are the decisive factors in the prevention of infectious complications when performing intravitreal injections. An additional measure of preventingsuch complications was the use of antiseptic miramistin, which was successfully tested and shown to provide a high level of antimicrobial protection in the absence of risk of developing resistance. Conclusions. The choice of antimicrobial agents as a means of preventing infectious complications of intravitreal injections should be made with consideration of the fact of their multiple administrationsand the clinical condition of the patient // Russian Ophthalmological Journal, 2016; 4: 11-5. doi: 10.21516/2072-0076-2016-9-4-11-15.