Abstract

DO.13.03

Procedure-related complications of intravitreal injection with anti-VEGF drugs

Einbock W., Sarra G.-M., Fleischhauer J., Wolf-Schnurrbusch U. E. K., Wolf S.
Klinik und Poliklinik für Augenheilkunde, Universität Bern, Inselspital, Bern, Schweiz

Objective: We evaluated retrospectively (17 month) intra- and postoperative ophthalmologic complications of in 635 intravitreal injections with 0.05 ml Avastin (Bevacizumab) and 651 intravitreal injections with 0.05 ml Lucentis (Ranibizumab).
Methods: 1286 intravitreal injections (1-13 injections per eye) were performed according to the guidelines of DOG and BVA in sterile operation conditions. A surgical desinfection of the periocular skin with Polividoniodine and 90 sec. desinfection of the conjunctiva with Polividoniodine 10% was performed. For the intravitreal injection we used a 25 G needle (0,5x16mm).
Results: 287 patients developed a hyposphagma which resolved spontaneously. 986 patients showed postoperative conjunctival hyperemia and epithelial disturbances. 5 patients had a postoperative erosio cornea. In 3 patients we observed a sudden postoperative increase of IOP, which had to be treated with anterior chamber paracenteses. In one patient we induced a subretinal bleeding due to a falsely used 25 G l needle (0,5x25mm). One patient showed a severe intravitreal inflammation on the first postoperative day, which had successfully treated with intravitreal antibiotics. One patient developed an intravitreal haemorrhage which spontaneous clearing.
Conclusions: In about 25% of the patients we observed mild and temporary postoperative side effects without need for additional treatment. Substantial IOP increase is possible, maybe related to the consistence of the vitreous. Following the published guidelines severe complications are very rare even in repeated injections.

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