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Doshi, Rishi R., MD*; Leng, Theodore, MD, MS; Fung, Anne E., MD

doi: 10.1097/IAE.0b013e31822c2958
Original Study: PDF Only

Purpose To provide experimental evidence to support or refute the proposition that the use of surgical face masks and/or avoidance of talking can decrease the dispersion of respiratory flora during an intravitreal injection.

Methods Ten surgeons recited a 30-second standardized script with blood agar plates positioned 30 cm below their mouths. The plates were divided into 4 groups, with 10 plates per group. In Group 1, participants did not wear a face mask. In Group 2, participants wore a standard surgical mask. In Group 3, no mask was worn, but plates were pretreated with 5% povidone–iodine. In Group 4, no mask was worn, and participants remained silent for 30 seconds. The plates were then incubated at 37°C for 24 hours, and the number of colony-forming units (CFUs) was determined.

Results Mean bacterial growth were as follows: Group 1, 8.6 CFUs per subject; Group 2, 1.1 CFUs per subject; Group 3, 0.1 CFUs per subject; and Group 4, 2.4 CFUs per subject. Differences between the groups were statistically significant (P < 0.05), with the exception of Group 2 versus Group 4 (P = 0.115).

Conclusion The use of a face mask and avoidance of talking each significantly decreased the dispersion of bacteria. Even without these interventions, plates pretreated with povidone–iodine demonstrated the least bacterial growth.

Use of a surgical face mask and avoidance of talking significantly reduced the dispersion of upper respiratory flora from healthy ophthalmologists onto a sterile surface.

*Department of Ophthalmology, California Pacific Medical Center, San Francisco, California

Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California

Pacific Eye Associates, California Pacific Medical Center, San Francisco, California.

Reprint requests: Anne E. Fung, MD, Pacific Eye Associates, California Pacific Medical Center, 2100 Webster Street 214, San Francisco, CA 94115; e-mail:

Supported by the Pacific Vision Foundation, San Francisco, CA.

The supporters had no role in study design, data collection, analysis, interpretation, writing of the report, or the decision to submit for publication.

All authors had an equal role in these endeavors.

The authors have no proprietary interest in any of the materials described in this article.

The authors declare no conflict of interest.

© 2019 by Ophthalmic Communications Society, Inc.