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Retina. 2007 Jun;27(5):609-12.
Risk for eye splash injury during administration of intraocular injections: a study of retina specialists and fellows.
Bourla DH, Wirthlin RS, Bourla N, Gupta A, Stanescu-Segall D, Schwartz SD, Axer-Siegel R.
Jules Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California-Los Angeles, 200 Stein Plaza, Los Angeles, CA 90095, USA. bourla@jsei.ucla.edu
OBJECTIVE: To evaluate the use of eye protection and frequency of eye splash events during intraocular injections as well as infection risk awareness among retina specialists and fellows in training. METHODS: In a prospective survey of practicing retina specialists and retina fellows, frequency of use and type of eye protection employed during intraocular injections, frequency of eye splash occurrences, description of the eye splash event, number of procedures performed, and awareness of transconjunctival infection risk were investigated. RESULTS: Sixty-four ophthalmologists responded to the questionnaire: 40 retina fellows and 24 retina specialists. The response rate was 100%. Twenty-five percent of the fellows and 33.3% of the specialists reported using eye protection, including corrective glasses, during all intraocular injections. Two of the retina fellows and none of the specialists used special forms of eye protection. Retina fellows had a mean +/- SD of 2.1 +/- 1.3 years experience and the specialists had a mean +/- SD of 10.4 +/- 6.7 years experience in performing intraocular injections. The mean number of injections +/- SD performed by the fellows and specialists was 23 +/- 14.6 and 35 +/- 11.9 per month, respectively. Twelve conjunctival or corneal splash occurrences were reported by six fellows and two retina specialists. Eleven splash events occurred due to reflux of fluid during administration of subconjunctival anesthetic injection, and one event occurred during an anterior chamber tap. Splash events were significantly more likely to occur during procedures performed by fellows, with a relative risk of 8.4 for unprotected procedures (P< 0.001, Fisher exact test). Most (87.5%) of the participants were aware of the risk for transconjunctival viral infection. CONCLUSION: Special eye protection is seldom used during administration of intraocular injections. Although the risk for eye splash during administration of subconjunctival anesthetic before intraocular injections is relatively small, protective measures may be considered when treating high-risk patients.