臨床眼科67巻11号

2013年10月発行

特集 図で早わかり 実戦！眼科薬理 Ⅰ．眼科臨床薬理総論

硝子体内注射のコツ

著者： 島田宏之¹

所属機関： ¹日本大学医学部視覚科学系眼科学分野

ページ範囲：P.28 - P.32

POINT

◎医師，看護師は必ず帽子とマスクを使用する。患者は帽子を使用し，口はマスクかドレープで覆う。

◎眼瞼皮膚を10％ヨード，結膜を0.25％ヨードで洗浄する。開瞼器を設置後に再度，結膜を0.25％ヨードで洗浄する。

◎結膜囊に0.25％ヨードが残った状態で30秒間待ってから硝子体内注射をする。

参考文献

1）Shimada H, Hattori T, Mori R et al：Minimizing the endophthalmitis rate following intravitreal injections using 0.25％ povidone-iodine irrigation and surgical mask. Graefes Arch Clin Exp Ophthalmol 2013 Feb 7［Epub ahead of print］

2）Lundstrom M, Wejde G, Stenevi U et al：Endophthalmitis after cataract surgery；a nationwide prospective study evaluating incidence in relation to incision type and location. Ophthalmology　114：866-870, 2007

3）Oshika T, Hatano H, Kuwayama Y et al：Incidence of endophthalmitis after cataract surgery in Japan. Acta Ophthalmol Scand　85：848-851, 2007

4）Simunovic MP, Rush RB, Hunyor AP et al：Endophthalmitis following intravitreal injection versus endophthalmitis following cataract surgery；clinical features, causative organisms and post-treatment outcomes. Br J Ophthalmol　96：862-866, 2012

5）Aiello LP, Brucker AJ, Chang S et al：Evolving guidelines for intravitreous injections. Retina　24：S3-19, 2004

6）de Caro JJ, Ta CN, Ho HK et al：Bacterial contamination of ocular surface and needles in patients undergoing intravitreal injections. Retina　28：877-883, 2008

7）McCannel CA：Meta-analysis of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents；causative organisms and possible prevention strategies. Retina　31：654-661, 2011

8）Doshi RR, Leng T, Fung AE：Reducing oral flora contamination of intravitreal injections with face mask or silence. Retina　32：473-476, 2012

9）Shah CP, Garg SJ, Vander JF et al：Outcomes and risk factors associated with endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmology　118：2028-2034, 2011

10）Moss JM, Sanislo SR, Ta CN：A prospective randomized evaluation of topical gatifloxacin on conjunctival flora in patients undergoing intravitreal injections. Ophthalmology　116：498-501, 2009

11）Milder E, Vander J, Shah C et al：Changes in antibiotic resistance patterns of conjunctival flora due to repeated use of topical antibiotics after intravitreal injection. Ophthalmology　11：1420-1424, 2012

12）Cheung CS, Wong AW, Lui A et al：Incidence of endophthalmitis and use of antibiotic prophylaxis after intravitreal injections. Ophthalmology　119：1609-1614, 2012