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Simultaneous intravitreal injections delivered bilaterally well-tolerated, study finds
Am J Ophthalmol. 2009;148(1):66-69.
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Use of separate instruments and careful patient counseling assisted in achieving good results with bilateral simultaneous intravitreal injections, a study found.
"Simultaneous bilateral intravitreal injections in the office are well-tolerated," the authors said. "A separate povidone-iodine preparation, speculum, needle and syringe were used for each eye. ... Patients should be counseled as to the risk of complications."
The study, a retrospective case series, was a review of 35 patients who underwent 208 simultaneous bilateral intravitreal injections. Each patient received an average of 5.9 injections. Of those patients, 133 eyes were administered Avastin (bevacizumab, Genentech), 14 eyes received bevacizumab plus preservative-free intravitreal triamcinolone or Triesence (Bristol-Myers Squibb), 56 eyes received Lucentis (ranibizumab, Genentech), and five eyes received bevacizumab plus Decadron (dexamethasone, Merck), the study said.
The researchers measured IOP, visual acuity and complications before and after injection.
Visual acuity averaged 20/96 before the injections and 20/91 at the next follow-up. The change was not statistically significant.
A painless, culture-negative endophthalmitis was reported in one eye 3 days after injection of bilateral bevacizumab, the study said. At 1 year, that eye had experienced an improvement in visual acuity from 20/400 to 20/80.