Sicherheit, Effektivität und protektive Wirkung einer Parazentese bei intravitrealen Injektionen: „Eine Lanze für die Parazentese brechen“

Koss, Michael; Bolz, Matthias; Augustin, Albert J.; Koch, Frank; Szurman, Peter; Stanzel, Boris V.; Fauser, Sascha; Mennel, Stefan; Vossmerbäumer, Urs; Smet, Marc D. de; Höhn, Fabian; Küchle, Michael; Lorenz, Birgit; Lüke, Matthias; Lytvynchuk, Lyubomyr; Meyer, Carsten H.; Paul, Christoph C.; Rodrigues, Eduardo B.; Schrage, Norbert; Zehetner, Claus

doi:10.1055/a-0972-9747

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…Although in some studies IOP lowering medications before intravitreal injection resulted in effective IOP control after injection, [16][17][18][19] in other cases they did not determine statistically significant reductions in postinjection IOP rise and therefore their application in prophylaxis is not currently recommended, even if this approach may warrant further investigations. 20,21 An option quite frequently performed is anterior chamber (AC) paracentesis, a cost-effective procedure to immediately reduce pathological IOP rise, 22 but with several potential complications including pain, traumatic injuries of the iris, iris incarceration, hyphema, severe inflammation, infection, persistent leakage with ocular hypotension, retinal hemorrhages due to rapid decrease of IOP, endophthalmitis and lens injuries. 23,24 The decompressive treatments have shown good results without being invasive.…”

Section: Introductionmentioning

confidence: 99%

<p>Reduction of Intraocular Pressure Spikes Due to Intravitreal Bevacizumab Injections by Scleral Indentation with Cotton Swab or Digital Ocular Massage: Innovative Techniques Compared</p>

Nuzzi

Scalabrin

Becco

2020

OPTH

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This study aims to evaluate the effectiveness of different decompressive injection techniques in reducing intraocular pressure (IOP) spikes, if compared to the injection without pressure applied on the eye, following the intravitreal injection of bevacizumab. Patients and Methods: Two hundred patients with indication to intravitreal therapy were randomized into five arms: 40 received intravitreal injection without ocular decompression (arm A), 40 with pre-injection scleral indentation with cotton swab (arm B), 40 with preinjection digital ocular massage (arm C), 40 with post-injection scleral indentation with cotton swab (arm D) and 40 with post-injection digital ocular massage (arm E). All patients underwent measurement of the IOP with Goldamm applanation tonometer 10 minutes before and 10 minutes after the injection. The primary endpoint of the study was variation of the post-injection IOP with the different techniques. Results: An increase in post-injection IOP was observed in all the arms, if compared to preinjection values. The greatest increase was observed in arm A with a mean IOP rise of 17.60 mmHg. All other techniques showed lower mean IOP increases: arm B 10.76 mmHg, arm C 9.35 mmHg, arm D 8.8 mmHg, arm E 3.4 mmHg. The post-injection IOP differences of innovative techniques compared to the technique without ocular decompression were all statistically significant (p-value <0.01). If compared to arm A (35%), a reduction in IOP spike ≥40 mmHg frequency was also observed. The status of phakia/pseudophakia, a previous diagnosis of glaucoma and the underlying pathology for which indication was given to inject bevacizumab did not significantly alter the post-injection IOP in any of the protocols. Conclusion: The introduction of new injection protocols, such as injections performed before or after decompressive treatments, could be a safe and effective approach to control post-injection IOP increase.

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Section: Introductionmentioning

confidence: 99%

<p>Reduction of Intraocular Pressure Spikes Due to Intravitreal Bevacizumab Injections by Scleral Indentation with Cotton Swab or Digital Ocular Massage: Innovative Techniques Compared</p>

Nuzzi

Scalabrin

Becco

2020

OPTH

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“…Der Beitrag von Koss et al [1] ist ein Lehrstück für "gute Wissenschaftlichkeit", wägt er doch (fast) alle Aspekte der intravitrealen operativen Medikamenteneingabe (IVOM) und der Parazentese sorgsam gegeneinander ab. Man fühlt sich, nicht nur weil "Graefe-Jahr" ist, an Albrecht von Graefe (1828-1870) mit seiner strengen Indikationsstellung und an den Graefe-Schüler Carl Wilhelm von Zehender (1819-1916) erinnert, der 1888 meinte "Der akademische Lehrer ist der Lehrer der nachwachsenden Generation; er hat als solcher die Aufgabe, nicht das zur Zeit gerade als richtig und wichtig Geltende zu lehren, sondern, immer und immer wieder, Altes und Neues zu prüfen, um das Beste lehren zu können" [2].…”

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Sicherheit, Effektivität und protektive Wirkung einer Parazentese bei intravitrealen Injektionen. Zum Beitrag von M. J. Koss et al. (Leserbrief)

Rohrbach

2020

Klin Monbl Augenheilkd

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Sicherheit, Effektivität und protektive Wirkung einer Parazentese bei intravitrealen Injektionen: „Eine Lanze für die Parazentese brechen“

Cited by 2 publications

References 24 publications

<p>Reduction of Intraocular Pressure Spikes Due to Intravitreal Bevacizumab Injections by Scleral Indentation with Cotton Swab or Digital Ocular Massage: Innovative Techniques Compared</p>

<p>Reduction of Intraocular Pressure Spikes Due to Intravitreal Bevacizumab Injections by Scleral Indentation with Cotton Swab or Digital Ocular Massage: Innovative Techniques Compared</p>

Sicherheit, Effektivität und protektive Wirkung einer Parazentese bei intravitrealen Injektionen. Zum Beitrag von M. J. Koss et al. (Leserbrief)

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