Effect of Prophylactic Intraocular Pressure-Lowering Medication on Intraocular Pressure Spikes After Intravitreal Injections

被引:49
作者
Frenkel, Max P. C.
Haji, Shamim A.
Frenkel, Ronald E. P.
机构
[1] Eye Research Foundation, Stuart, FL
[2] East Florida Eye Institute, Stuart, FL
关键词
MACULAR DEGENERATION; TRIAMCINOLONE; PARACENTESIS; PEGAPTANIB; NECESSITY; TRENDS;
D O I
10.1001/archophthalmol.2010.297
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Objective: To determine if prophylactic use of intraocular pressure (IOP)-lowering medication is effective in reducing the IOP spikes after intravitreal injections of pegaptanib, bevacizumab, and ranibizumab. Methods: Seventy-one patients with exudative age-related macular degeneration received intravitreal injections of 1 of 3 anti vascular endothelial growth factor medications: 30 patients received pegaptanib (0.09 mL), 47 patients received bevacizumab (0.05 mL), and 42 patients received ranibizumab (0.05 mL). Intraocular pressure lowering medication, 1 hour prior to the injection, was used 63%, 74%, and 66% of the time in eyes that received pegaptanib, ranibizumab, and bevacizumab, respectively. Intraocular pressure was measured prior to injection, within 1 minute after injection, and every 5 to 10 minutes until the pressure was reduced to a safe level. Results: All 3 intravitreal injections caused significant initial IOP spikes (mean [SD] IOP of 38.5 [11.56] mm Hg in the pegaptanib group, 37.75 [8.36] mm Hg in the ranibizumab group, and 34.88 [10.45] mm Hg in the bevacizumab group). The IOP reduced to less than 30 mm Hg in all 3 groups within 20 minutes. Prophylactic medication did not prevent postinjection IOP spikes. Patients with and without glaucoma showed a similar rate of IOP normalization over time in all 3 groups. Conclusion: Intraocular pressure spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab are common and in most cases transient. Routine prophylactic use of IOP-lowering medications is essentially ineffective in preventing IOP spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab and therefore not necessary before the injection.
引用
收藏
页码:1523 / 1527
页数:5
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