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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
DO.04.01 Intravitreal Injections Heimann H.
St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom Objective: The introduction of new drugs in the treatment of AMD has led to a considerable increase of intravitreal injections in recent years. A correct injection method is a prerequisite for the safe application of these new treatment methods in clinical practice.
Methods: Review of studies published on intravitreal injections and of the recommendations of the German Ophthalmological Associations.
Results: Postoperative complications are related to the applied substance and the technique used. A low-grade intraocular inflammation can be noted after approximately 25% of all injections; no additional therapy is usually needed. The most important postoperative complication is bacterial endophthalmitis that, after the application of anti-VEGF substances, occurs in about 0.2% of all injections and in about 1.2% of all patients treated with repeated injections. A decrease in the postoperative endophthalmitis rate could be achieved with improvement of the injection technique (e.g. use of lid speculum, injection under sterile conditions). The rate of postoperative endophthalmitis seems to be higher following the injection of triamcinolone (about 1.4% of all injections). An increase in intraocular pressure and a cataract progression could almost exclusively be noted following triamcinolone injection, but not after anti-VEGF therapy. Rare complications, irrespective of the substance used, are iatrogenic trauma of the lens or the retina (about 0.07% of injections and 0.6% of patients treated with repeat injections).
Conclusions: The new treatment methods with intravitreal injections are safe procedures with a low complication rate, provided an appropriate injection technique is applied. Intravitreal injections of triamcinolone are associated with a higher rate of postoperative endophthalmitis, rise in intraocular pressure and cataract progression. Intravitreal injections should be performed following the guidelines of the German Ophthalmology Society (1).
(1) http://www.dog.org/publikationen/stellungnahme_AMD.html
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