A protocol for the retina surgeon's safe initial intravitreal injections.

Area of Science:

• Ophthalmology
• Retinal Diseases
• Surgical Safety

Background:

• Intravitreal injections are a common treatment for neovascular age-related macular degeneration (nAMD).
• Ensuring the safety of initial procedures performed by surgeons is crucial for patient outcomes.
• Standardized protocols are essential for minimizing risks associated with intravitreal injections.

Purpose of the Study:

• To evaluate the safety of a surgeon's first consecutive intravitreal injections.
• To identify and review complications potentially linked to the intravitreal injection procedure.
• To assess the safety profile of a specific injection protocol in an office-based setting.

Main Methods:

• Retrospective chart review of 59 patients undergoing intravitreal injections.
• Analysis of 345 injections administered for nAMD, including pegaptanib, bevacizumab, and ranibizumab.
• Inclusion of pre-injection procedures (povidone-iodine, antibiotics, speculum) and post-injection evaluations (vision, IOP).

Main Results:

• No cases of endophthalmitis, toxic reactions, traumatic cataracts, retinal detachment, or vitreous hemorrhage were reported.
• Minor complications included lid swelling, transient floaters, RPE tear, corneal edema, and abrasion.
• Five instances of transient no light perception occurred following pegaptanib injections.

Conclusions:

• The incidence of severe complications from intravitreal injections in this study was notably low.
• The specific protocol utilized demonstrated a high degree of safety for a surgeon's initial consecutive injections.
• The findings support the safe implementation of this protocol for intravitreal injections in clinical practice.