Can the dexamethasone intravitreal implant Ozurdex be safely administered in an out-of-operating room setting?

Figures & data

Table 1. Work protocol for intravitreal injections in controlled environment surgical cabin (ArcSterile^®).

Protocol

Intervention Staff: One Ophthalmologist One nurse One nurse assistant (recommended) Review of patient medical history and procedure to be performed. The nurse assistant calls the patient who is in the waiting room, puts on the dressing gown and cap. Patient checklist: To verify that the patient has signed the written informed consent to the procedure. Procedure to be performed. Eye to be treated. Out of the surgery cabin, three minutes before procedure starts, topical anesthetic (5% lidocaine) and 5% povidone iodine are applied on the surface of the eye. Once the patient is placed inside the surgery cabin, 5% lidocaine and 5% povidone iodine are applied topical and the skin is painted with 10% povidone iodine. A sterile pack per patient will be used. With the help of sterile gloves (and always with sterile mask) it is placed a sterile fenestrated cloth and an eyelid speculum over the eye to be treated. 5% lidocaine and 5% povidone iodine are applied again on the surface of the eye. Proceed to the intraocular injection previous marked with compass.^a Mobilization of the conjunctiva with a surgical microsponge, injection, and reposition of the conjunctiva. Removal of eyelid speculum and sterile fenestrated cloth. Once the intervention is concluded, the ophthalmologist will indicate to the patient the postoperative care, which will be written in a report, and when to request the appointment for re-evaluation in the office

^a Dexamethasone intravitreal implant (Ozurdex^®) 0.7 was placed into the vitreous cavity following standard indications³¹.

Figure 1. Number of eyes treated with the intravitreal dexamethasone implant Ozurdex. Abbreviations. CESC: controlled environment surgical cabin; OR: operating room. First: Years 2011 and 2015 for the OR and CESC, respectively. Second: Years 2012 and 2016 for the OR and CESC, respectively. Third: Years 2013 and 2017 for the OR and CESC, respectively. Fourth: Years 2014 and 2018 for the OR and CESC, respectively. Fifth: Years 2015 and 2019 for the OR and CESC, respectively. *From 10 May 2011 in the OR and from 4 March 2015 in the CESC. **Until 19 February 2015 in the OR and till 25 June 2019 in the CESC.

Guigou S, Pommier S, Meyer F, et al. Efficacy and safety of intravitreal dexamethasone implant in patients with diabetic macular edema. Ophthalmologica. 2015;233(3–4):169–175.

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