Some clinicians may worry about injection frequency in eyes of patients with wet AMD after pars plana vitrectomy (PPV) due to perceived increased medication clearance, but a study in Ophthalmology Retina suggests a majority of these individuals may need fewer injections post-surgery.
Researchers from Minnesota also found a low rate of rhegmatogenous retinal detachment in post-PPV patients who received intravitreal injections over a 90-day period, although when retinal detachments did occur, they were more difficult to repair.
The single-center retrospective review looked at a cumulative total of 203,00 anti-VEGF treatments for wet AMD between 2014 and 2018 and identified 17 patients with rhegmatogenous retinal detachments within 90 days of an intravitreal injection—a rate of 0.0084%.
The PPV patients received a mean of 27.56 injections in the superotemporal quadrant prior to retinal detachment. Of known retinal breaks, the superotemporal quadrant was most frequently involved (62.5%), and six patients (35.3%) required a second surgery. For patients who needed postoperative injections, the average interval increased from 7.18 weeks pre-op to 9.17 weeks after the procedure.
Additionally, 64.7% of patients either increased their injection intervals or required no further injections, while three maintained similar intervals and another three had decreased intervals. The average number of injections in the six months prior to retinal detachment (84) and in the six months after the first post-PPV injection (47) was 4.94±1.89 and 2.76±2.44, respectively.
Liang Q, Le Q, Cordova DW, et al. Corneal epithelial thickness measured using AS-OCT as a diagnostic parameter for limbal stem cell deficiency. Am J Ophthalmol. April 10, 2020. [Epub ahead of print].