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.