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M. P. Frenkel, R. E. P. Frenkel, S. Haji; The Effect of Prophylactic Use of IOP Lowering Medication on IOP Spikes After Intravitreal Injections. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5020.
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To determine if prophylactic use of IOP lowering medication is effective in reducing the IOP spikes after intravitreal injections of Pegaptanib (Macugen), Bevacizumab (Avastin), and Ranibizumab (Lucentis).
300 eyes with exudative AMD received intravitreal injections of one of three anti-VEGF medications: 100 eyes received Macugen (0.09 ml), 100 received Avastin (0.05ml), and 100 received Lucentis (0.05ml). IOP lowering medication, one hour prior to the injection, was used in 84 %, 56% and 68% times in eyes that received Macugen, Lucentis and Avastin respectively. IOP was measured prior to injection, within one minute after injection, and every 5-10 minutes until the pressure was reduced to a safe level. Vision was evaluated immediately following injection.
All three injections caused significant initial IOP spikes. 71.42% of Macugen, 46 % of Avastin and 56 % of Lucentis patients had a post-injection IOP spike greater than 40 mmHg. The IOP reduced to less than 30 mmHg in all three groups within 20 minutes.Prophylactic medication did not prevent post-injection IOP spikes. There was no statistically significant IOP reduction except at 1 interval in each Macugen and Avastin group.
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