Abstract

SA.16.10

Different injection-techniques and their influence on intraocular pressure (IOP) after intravitreal ranibizumab application

Fabian Höhn, Lars-Olof Hattenbach, Alireza Mirshahi
Augenklinik, Klinikum Ludwigshafen, Ludwigshafen

Objective
This prospective study examines the influence of different intravitreous injection-techniques on the short-term intraocular pressure (IOP) in patients with exudative age-related macular degeneration (AMD) receiving 0.05 ml ranibizumab (Lucentis®) in supine position.
Methods
45 eyes (45 patients, 16 m, 29 f, mean age: 78 y) received intravitreal ranibizumab injections for treatment of exudative AMD (0.05 ml = 0.5 mg). 31 got a standard straight scleral incision, whereas 14 were injected through a tunneled scleral. The IOP was measured by Schiøtz tonometry immediately pre- and postoperatively and the amount of reflux was noted. 23 eyes were phakic and the remaining 22 were pseudophakic. No history of glaucoma was present. The two-tailed T-Test was used for the statistical analysis.
Results
The mean preoperative IOP was 22.4 ± 5.5 mmHg in the supine position. Immediately after the injection, IOP increased to 47.9 ± 15.1 (range 23-82). The mean difference between preoperative IOP and immediately after the injection was +25.5 ± 13.6 mmHg. The IOP mean difference in eyes receiving a standard straight scleral incision was 21.9 ± 14.2 mm Hg (median 22.3), whereas the tunneled scleral incision eyes IOP increase was 33.5 ± 7.2 mm Hg (median 34.5). This difference is significant (p=0.001).
Conclusions
IOP increased significantly in a considerable number of patients after receiving 0.05 ml intravitreal ranibizumab injections. The rise depends on the intravitreal injection technique.and is significantly higher if a tunneled scleral injection is done.

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