[Combined intravitreal therapy for age-related macular disease]

Since the introduction of anti-VEGF drugs for the treatmet of CNV in age-related macular degeneration (AMD), visual acuity can be stabilised or improved in a significant number of patients. There is an ongoing debate on the safety, efficiency and economic aspects related to current intravitreal therapeutic concepts. Twenty-four to 36 hours after 80 % low-fluence verteporfin photodynamic therapy (PDT) a combined phrarmacosurgical intravitreal therapy for 52 patients with wet AMD was conducted (multiple therapy). By performing a 23-gauge core vitrectomy with the Intrector, an intravitreal substitution with BSS, dexamethasone and bevacizumab was achieved via a self-adapting two-channel cannula for aspiration and injection in one probe tip. After 14 months the mean gain in visual acuity (VA) was 0.18 Snellen lines, with VA stabilisation in 14 / 52 (27 %) and VA gain in 38 / 52 (73 %) of the patients. This safe pharmacosurgical regimen indicated a low intravitreal retreatment rate of (13 / 52) 25 %.