Abu-Yaghi Nakhleh E, Shokry Ahmed N, Abu-Sbeit Rami H
Department of Ophthalmology, Faculty of Medicine, the University of Jordan, Amman 11118, Jordan.
Int J Ophthalmol. 2014 Dec 18;7(6):1017-21. doi: 10.3980/j.issn.2222-3959.2014.06.20. eCollection 2014.
To document the indications, safety and possible complications of bilateral same-session intravitreal anti-vascular endothelial growth factor (VEGF) injections performed in the ophthalmic operating room.
A retrospective case series study. Consecutive records of seventy four patients receiving simultaneous bilateral intravitreal injections of either ranibizumab or bevacizumab, between September 2010 and September 2013, were reviewed and the outcomes were assessed. Data collected included number of injections, indications for injections, pre-injection and post-injection visual acuity (VA), pre-injection and post-injection intraocular pressure and ocular and systemic complications/complaints after each injection.
A total of 342 injections were administered to 74 patients, with a mean of 4.62 injections per patient. Seventy-three patients received bevacizumab (Avastin; Genentech Inc., South San Francisco, California, USA) alone, and only one patient received both bevacizumab and ranibizumab (Lucentis; Genentech Inc.) distributed between the injections. Pre- and post-injection VA follow-up measurements were available for 65 patients. Mean follow up period was 22mo. The indications for initiating therapy were choroidal neovascular membrane from age-related macular degeneration (3 patients) and diabetic macular edema (71 patients). The mean Snellen VA before each injection was 6/22. The next post-injection follow-up mean Snellen VA was 6/20. One patient had a painful, culture-positive endophthalmitis in one eye 3d after bilateral bevacizumab. Another patient had a painless subconjunctival hemorrhage in one eye. No other ocular or systemic adverse side effects/complaints have been registered in this study group.
Bilateral same-session intravitreal injections using a separate povidone-iodine preparation, speculum, needle, and syringe for each eye are well-tolerated. None of the subjects in this study requested to switch to alternating unilateral injections. Proper patient counseling as to the risk of complications with this procedure is necessary.
记录在眼科手术室进行双眼同期玻璃体内注射抗血管内皮生长因子（VEGF）的适应证、安全性及可能的并发症。
一项回顾性病例系列研究。回顾了2010年9月至2013年9月期间连续74例接受雷珠单抗或贝伐单抗双眼同期玻璃体内注射患者的记录，并对结果进行评估。收集的数据包括注射次数、注射适应证、注射前和注射后视力（VA）、注射前和注射后眼压以及每次注射后的眼部和全身并发症/不适。
74例患者共接受342次注射，平均每位患者4.62次注射。73例患者仅接受贝伐单抗（阿瓦斯汀；基因泰克公司，美国加利福尼亚州南旧金山）注射，仅1例患者在不同次注射中分别接受了贝伐单抗和雷珠单抗（雷珠单抗；基因泰克公司）注射。65例患者有注射前和注射后VA随访测量数据。平均随访期为22个月。开始治疗的适应证为年龄相关性黄斑变性引起的脉络膜新生血管膜（3例）和糖尿病性黄斑水肿（71例）。每次注射前平均Snellen视力为6/22。下次注射后随访平均Snellen视力为6/20。1例患者在双眼注射贝伐单抗后3天，一只眼发生疼痛、培养阳性的眼内炎。另1例患者一只眼出现无痛性结膜下出血。该研究组未记录到其他眼部或全身不良副作用/不适。
双眼同期玻璃体内注射时，每只眼使用单独的聚维酮碘制剂、窥器、针头和注射器，耐受性良好。本研究中没有受试者要求改为交替单眼注射。有必要就该操作的并发症风险对患者进行适当的咨询。
