Post Vitrectomy Endophthalmitis related to wearing of face mask on the rise during COVID-19 pandemic

A recent study found that there was an increased incidence of Endophthalmitis after Vitrectomy during the COVID-19 face mask wearing period. The study was published in the British Journal of Ophthalmology, 2022.

With the worldwide spread of the COVID 19 pandemic, wearing a face mask was made mandatory to reduce the spread of droplet infection. It was recently found that when worn inappropriately, face masks can cause Infectious Keratitis due to the air carrying the oral flora bacteria from inside the mask to the eye. Researchers from Japan conducted a study to determine the incidence and causative pathogens of endophthalmitis after Vitrectomy during the strict face mask-wearing COVID-19 period.

A retrospective multicentre study including 31 ophthalmological institutions of the Japanese Retina and Vitreous Society or Japan-Clinical Retina Study group was conducted. Subjects who underwent vitrectomy during 2019, the pre-COVID-19 period, and from July 2020 to June 2021, the COVID-mask period, were included. Cataract surgery results were used as a control in the study. The total number of vitrectomies and the total number of postoperative endophthalmitis were determined and also the differences in the incidence of postoperative endophthalmitis between the pre-COVID-19 period and the COVID-mask period were studied. The type of pathogens causing the endophthalmitis were also studied.

The key findings from the study were as follows:

• The incidence of post vitrectomy endophthalmitis was significantly lower in the pre-COVID-19 period with 16,568 surgeries and 18 endophthalmitis cases (0.11%) than in the COVID-mask period of 14,929 surgeries and 31 endophthalmitis cases (0.21%; p=0.031, OR=1.913, 95% CI 1.078 to 3.394).
• In the pre-COVID-19 period, 4 of the 18 eyes were culture positive, and all were of the Staphylococcus family.
• In the COVID-mask period, 9 of the 31 eyes were culture positive, and 4 cases were related to oral commensals including Streptococcus spp, which are reportedly very rare in endophthalmitis after vitrectomy.

Thus the researchers concluded that physicians should be aware of the higher incidence of post vitrectomy endophthalmitis during the COVID-mask period, and also suggested that the patients should be treated accordingly.

For the full article, click here: Sakamoto T, Terasaki H, Yamashita T, et alIncreased incidence of endophthalmitis after vitrectomy relative to face mask wearing during COVID-19 pandemicBritish Journal of Ophthalmology Published Online First: 21 June 2022. doi: 10.1136/bjophthalmol-2022-321357