Researchers conducted a large review of existing studies to see if using antibiotic eye drops before or after intravitreal injections helps prevent a serious eye infection called endophthalmitis. Intravitreal injections are a common treatment for conditions like macular degeneration. The analysis combined data from studies involving over 3 million injections and more than 1,400 infection cases.
The main finding was that patients who received topical antibiotic prophylaxis did not have a lower rate of endophthalmitis compared to patients who did not receive the antibiotics. The odds of infection were not significantly different between the two groups. Furthermore, there was no significant difference in the final visual acuity (sharpness of vision) between the groups, though the antibiotic group showed a very small, non-significant decrease.
This was a meta-analysis of observational studies, which means it can show a link but cannot prove cause and effect. The study did not report on specific safety concerns or side effects from the antibiotic use. Based on this evidence and the potential risks of unnecessary antibiotic use, the authors note that routine antibiotic prophylaxis for these injections is not recommended. Readers should understand this as a large-scale analysis suggesting current practice may not need to change, but individual decisions should always be made with an eye doctor.