Impact of Injection Techniques on Intraocular Pressure (IOP) Increase After Intravitreal Ranibizumab Application

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2010 Apr 22

PMID 20407785

Citations 11

Authors

Fabian Hohn

Alireza Mirshahi

Affiliations

Soon will be listed here.

Abstract

Purpose: To examine the influence of different intravitreous injection techniques on the short-term intraocular pressure (IOP) in patients with exudative age-related macular degeneration (AMD) receiving 0.05 ml ranibizumab (Lucentis) in the supine position.

Methods: Forty-five eyes (45 patients, 16 male, 29 female, mean age: 78 years) received intravitreal ranibizumab injections for treatment of exudative AMD (0.05 ml = 0.5 mg). A total of 31 patients received a standard straight scleral incision, and 14 were injected using the tunneled sclera technique. IOP was measured by Schiøtz tonometry immediately pre-and postoperatively, and the amount of subconjunctival reflux was documented using a semi-quantitative scale. Twenty-three eyes were phakic, and the remaining 22 were pseudophakic. No history of glaucoma was present. The Wilcoxon matched-pairs test was used for comparisons.

Results: The mean preoperative IOP was 22.4 +/- 5.5 mmHg in the supine position. Immediately after the injection, the IOP increased to 47.9 +/- 15.1 (range 23-82). The mean difference between preoperative IOP and immediately after the injection was 25.5 +/- 13.6 mmHg. The mean IOP increase in eyes receiving a standard straight scleral incision was 21.9 +/- 14.2 mmHg (median 22.3) versus 33.5 +/- 7.2 mmHg (median 34.7) in the tunneled scleral incision group (p = 0.001).

Conclusions: IOP increased significantly in a considerable number of patients after receiving 0.05-ml intravitreal ranibizumab injections. This increase was dependent on the intravitreal injection technique and was significantly higher if a tunneled scleral injection was performed.

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