[Technique of intravitreal drug injection for therapy of vitreoretinal diseases].

Abstract

Intravitreal injections are the standard technique applied in the treatment of some vitreoretinal diseases. In this paper the technique and complications of intravitreal injections are presented. In summary, the procedure involves various consecutive steps. Initially, days before the treatment topical antibiotics and acetazolamide may be prescribed for reduction of the ocular flora and intraocular pressure. Before the injection, the pupil should be dilated and topical anesthesia should be achieved. Injection shall be performed in the operating room under sterile conditions, the surgeon should wear surgical gloves and mask. The eye is then exposed with sterile blepharostat and sterile-drape thereby providing protection of the needle against the contact with contaminated lashes and lids. Injection is done 3.5 mm from the limbus through the pars plana. The needle should be inserted up to 6 mm into the vitreous cavity. Immediately after injection the patient must be examined by indirect ophthalmoscopy to verify central artery perfusion and complications as vitreous hemorrhage. Visual acuity better than light perception should be detected right after injection. If persistent central retinal artery occlusion is diagnosed, anterior chamber paracentesis should be performed. The patient may be discharged with an occlusive patch. Examination at the first postoperative day should exclude various complications such as endophthalmitis, and topical steroid and antibiotics should be prescribed for 7 days. Some complications encountered after intravitreal injections include retinal detachment, vitreous hemorrhage, cataract, uveitis, ocular hypertension, or endophthalmitis.

• Authors: Eduardo Buchele Rodrigues, Mauricio Maia, Fernando Marcondes Penha, Eduardo Dib, Arnaldo Furman Bordon, Octaviano Magalhães Júnior, Michel Eid Farah
• Journal: Arquivos brasileiros de oftalmologia (Arq Bras Oftalmol) 2008 Nov-Dec Vol. 71 Issue 6 Pg. 902-7 ISSN: 1678-2925 [Electronic] Brazil
• Vernacular Title: Técnica para injeção intravítrea de drogas no tratamento de doenças vítreorretinianas.
• PMID: 19169531 (Publication Type: English Abstract, Journal Article)

Chemical References

• Anti-Infective Agents, Local

Topics

• Anti-Infective Agents, Local (administration & dosage)
• Endophthalmitis (etiology, prevention & control)
• Eye Diseases (drug therapy)
• Humans
• Injections (adverse effects, methods)
• Needles
• Postoperative Care
• Preoperative Care
• Retinal Detachment (etiology, prevention & control)
• Retinal Diseases (drug therapy)
• Vitreous Body