Short-term complications of intravitreal injections of triamcinolone and bevacizumab

Abstract

Aims: To evaluate the rate of complications after intravitreal injection of bevacizumab and triamcinolone.

Methods: The clinical interventional case-series study included 5403 intravitreal injections of about 20 mg triamcinolone acetonide (n=1588) or 1.5 mg bevacizumab (n=3818) consecutively performed in the period from 2000 to 2007 by three surgeons for treatment of various intraocular edematous or neovascular diseases. Follow-up after each injection was at least 4 weeks.

Results: An infectious endophthalmitis which necessitated pars plana vitrectomy was detected in two eyes (2/5403 or 0.04+/-0.03%) from the bevacizumab group. Two eyes (2/5403 or 0.04+/-0.03%) from the bevacizumab group showed a painless vitreous clouding which subsided after intensified topical antibiotic therapy; one eye (1/5403 or 0.02+/-0.02%) developed a retinal detachment; and three eyes (3/5403 or 0.06+/-0.03%) (two eyes from the bevacizumab group) showed a rapidly progressive cataract. The total rate of these complications was 8/5403 (0.15+/-0.05%). It was statistically independent of the surgeon (P=0.18), the drug injected (P=0.45), and the age of the patients (P=0.87).

Conclusions: Injection-related complications such as infectious endophthalmitis, retinal detachment, and traumatic cataract may occur with a frequency of about 0.15+/-0.05% after intravitreal injections of bevacizumab or triamcinolone, independently of the drug injected.