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Purpose: Routine use of face masks for patients and physicians during intravitreal anti-vascular endothelial growth factor (VEGF) injections has increased with the emergence of the coronavirus disease 2019 pandemic. This study evaluates the impact of universal face mask use on rates and outcomes of post-injection endophthalmitis (PIE)., Design: Retrospective, multicenter, comparative cohort study., Participants: Eyes receiving intravitreal anti-VEGF injections from October 1, 2019, to July 31, 2020, at 12 centers., Methods: Cases were divided into a "no face mask" group if no face masks were worn by the physician or patient during intravitreal injections or a "universal face mask" group if face masks were worn by the physician, ancillary staff, and patient during intravitreal injections., Main Outcome Measures: Rate of endophthalmitis, microbial spectrum, and visual acuity (VA)., Results: Of 505 968 intravitreal injections administered in 110 547 eyes, 85 of 294 514 (0.0289%; 1 in 3464 injections) cases of presumed endophthalmitis occurred in the "no face mask" group, and 45 of 211 454 (0.0213%; 1 in 4699) cases occurred in the "universal face mask" group (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.51-1.18; P = 0.097). In the "no face mask" group, there were 27 cases (0.0092%; 1 in 10 908 injections) of culture-positive endophthalmitis compared with 9 cases (0.004%; 1 in 23 494) in the "universal face mask" group (OR, 0.46; 95% CI, 0.22-0.99; P = 0.041). Three cases of oral flora-associated endophthalmitis occurred in the "no face mask" group (0.001%; 1 in 98 171 injections) compared with 1 (0.0005%; 1 in 211 454) in the "universal face mask" group (P = 0.645). Patients presented a mean (range) 4.9 (1-30) days after the causative injection, and mean logarithm of the minimum angle of resolution (logMAR) VA at endophthalmitis presentation was 2.04 (~20/2200) for "no face mask" group compared with 1.65 (~20/900) for the "universal face mask" group (P = 0.022), although no difference was observed 3 months after treatment (P = 0.764)., Conclusions: In a large, multicenter, retrospective study, physician and patient face mask use during intravitreal anti-VEGF injections did not alter the risk of presumed acute-onset bacterial endophthalmitis, but there was a reduced rate of culture-positive endophthalmitis. Three months after presentation, there was no difference in VA between the groups., (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To report the rate, risk factors, and outcomes of rhegmatogenous retinal detachment (RRD) after intravitreal injection of anti-vascular endothelial growth factor medications., Design: Single-center, retrospective, consecutive review., Participants: All patients receiving ranibizumab, bevacizumab, or aflibercept for neovascular age-related macular degeneration or retinal vein occlusion between October 1, 2014, and October 1, 2017., Methods: The total number of eyes and injections were determined from billing codes. Rhegmatogenous retinal detachment patients were determined from billing records and confirmed with chart review., Main Outcome Measures: Rate of retinal detachment and visual acuity outcomes., Results: A total of 180 671 intravitreal injections in 12 718 unique patients were included. An RRD occurred in 24 patients within 3 months after injection, giving a rate of 1 RRD per 7532 intravitreal injections (0.013%) and 1 RRD per 530 patients (0.19%). No association was found between RRD risk after injection and diagnosis (P = 0.54), physician experience (P = 0.23), injection site (P = 0.41), caliper use (P = 0.75), or 31- versus 30-gauge needle use (P = 0.18). A retinal tear was found located in the quadrant of the injection site (within 1.5 clock hours of the injection) in 15 of 24 patients (62.5%; P < 0.0001). At the time of RRD diagnosis, the macula was attached in 9 patients (37.5%). Interventions for RRD repair included pars plana vitrectomy (PPV; 15 patients), combined scleral buckle and PPV (4 patients), pneumatic retinopexy (3 patients), and laser or cryotherapy alone (2 patients). Single-surgery success rate was 54.2%, with 54.5% of recurrent detachments caused by proliferative vitreoretinopathy. Average loss from visual acuity recorded at the visit before diagnosis of RRD was 1.0 line for macula-on detachments versus 6.8 lines for macula-off detachments (P = 0.027) at final follow-up (average, 16.3 months)., Conclusions: Retinal detachment after intravitreal injection is uncommon, with a rate of approximately 1 in 7500 injections. Macular status at the time of RRD diagnosis significantly affects visual outcomes., (Copyright © 2019 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)