TY - JOUR
T1 - Bilateral Simultaneous Intravitreal Injections in the Office Setting
AU - Bakri, Sophie J.
AU - Risco, Miguel
AU - Edwards, Albert O.
AU - Pulido, Jose S.
N1 - Funding Information:
This study was supported by the Research to Prevent Blindness, New York, New York. Dr Bakri has served on the advisory boards of Genentech Inc, Novartis, and Alcon Laboratories. The Mayo Clinic has received research funds for clinical trials from Genentech Inc, Regeneron, Novartis, and Potentia Pharmaceuticals. Involved in design and conduct of study (S.J.B.); collection, management, analysis, and interpretation of data (S.J.B., M.R., J.S.P., A.O.E.); and preparation, review, or approval of the manuscript (S.J.B., M.R., J.S.P., A.O.E.). Permission was obtained from the Institutional Review Board of the Mayo Clinic to conduct this retrospective review of patient records and to report these findings.
PY - 2009/7
Y1 - 2009/7
N2 - Purpose: To report the outcomes and complications of bilateral simultaneous intravitreal injections performed in the office. Design: Retrospective case series. Methods: Records of 35 patients receiving simultaneous bilateral intravitreal injections between November 2007 and November 2008 were reviewed. Data collected included indication for injection, preinjection and postinjection intraocular pressure (IOP), preinjection and postinjection visual acuity (VA), and complications/complaints after each injection. Results: A total of 208 injections were administered to 35 patients, with a mean of 5.9 injections per patient (range, 2 to 14; standard deviation [SD], 3.68). One hundred and thirty-three eyes received bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) alone, 14 received bevacizumab plus preservative-free intravitreal triamcinolone or Triescence (Kenalog; Bristol-Myers Squibb Co, New York, New York, USA), 56 received ranibizumab (Lucentis; Genentech Inc), and 5 received bevacizumab plus dexamethasone (Decadron; Merck, Whitehouse Station, New Jersey, USA). Mean time of postinjection follow-up was 39 days. Postinjection VA follow-up measurements were available for 194 injections. The indication for initiating therapy was choroidal neovascularization from age-related macular degeneration (49 eyes), diabetic macular edema (ME) (13 eyes), proliferative diabetic retinopathy (4 eyes), ME attributable to retinal vein occlusion (2 eyes), and ME attributable to autoimmune retinopathy (2 eyes). The mean VA before each injection was 20/96 and at the next follow-up was 20/91 (P = .40). One patient had a painless, culture-negative endophthalmitis in 1 eye 3 days after bilateral bevacizumab; at 1 year VA improved from 20/400 to 20/80. Conclusions: Simultaneous bilateral intravitreal injections in the office are well tolerated. A separate povidone-iodine preparation, speculum, needle, and syringe were used for each eye. None of the patients requested alternating unilateral injections, after receiving bilateral injections. Patients should be counseled as to the risk of complications.
AB - Purpose: To report the outcomes and complications of bilateral simultaneous intravitreal injections performed in the office. Design: Retrospective case series. Methods: Records of 35 patients receiving simultaneous bilateral intravitreal injections between November 2007 and November 2008 were reviewed. Data collected included indication for injection, preinjection and postinjection intraocular pressure (IOP), preinjection and postinjection visual acuity (VA), and complications/complaints after each injection. Results: A total of 208 injections were administered to 35 patients, with a mean of 5.9 injections per patient (range, 2 to 14; standard deviation [SD], 3.68). One hundred and thirty-three eyes received bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) alone, 14 received bevacizumab plus preservative-free intravitreal triamcinolone or Triescence (Kenalog; Bristol-Myers Squibb Co, New York, New York, USA), 56 received ranibizumab (Lucentis; Genentech Inc), and 5 received bevacizumab plus dexamethasone (Decadron; Merck, Whitehouse Station, New Jersey, USA). Mean time of postinjection follow-up was 39 days. Postinjection VA follow-up measurements were available for 194 injections. The indication for initiating therapy was choroidal neovascularization from age-related macular degeneration (49 eyes), diabetic macular edema (ME) (13 eyes), proliferative diabetic retinopathy (4 eyes), ME attributable to retinal vein occlusion (2 eyes), and ME attributable to autoimmune retinopathy (2 eyes). The mean VA before each injection was 20/96 and at the next follow-up was 20/91 (P = .40). One patient had a painless, culture-negative endophthalmitis in 1 eye 3 days after bilateral bevacizumab; at 1 year VA improved from 20/400 to 20/80. Conclusions: Simultaneous bilateral intravitreal injections in the office are well tolerated. A separate povidone-iodine preparation, speculum, needle, and syringe were used for each eye. None of the patients requested alternating unilateral injections, after receiving bilateral injections. Patients should be counseled as to the risk of complications.
UR - http://www.scopus.com/inward/record.url?scp=67349171525&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67349171525&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2009.02.013
DO - 10.1016/j.ajo.2009.02.013
M3 - Article
C2 - 19403114
AN - SCOPUS:67349171525
SN - 0002-9394
VL - 148
SP - 66-69.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 1
ER -