Patient-Reported Complications after Intravitreal Injection and Their Predictive Factors.
Ophthalmol Retina
; 5(7): 625-632, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33059077
ABSTRACT
PURPOSE:
The intravitreal injection (IVI) of pharmacologic agents is the most commonly performed ocular procedure and is associated with a host of complications. Most IVI-related complications data are derived from randomized controlled clinical trials, which report a high adverse event rate. The nature of these protocol-driven trials limit their applicability to the diverse circumstances seen in routine clinical practice. The goal of this study was to determine the prevalence of patient-reported IVI-related complications, their risk factors, and the manner in which patients sought treatment at a tertiary eye care center.DESIGN:
Retrospective, institutional review board-approved study.PARTICIPANTS:
Forty-four thousand seven hundred thirty-four injections in 5318 unique patients at the Cleveland Clinic Cole Eye Institute from 2012 through 2016.METHODS:
Intravitreal injection. MAIN OUTCOMEMEASURES:
Complication occurrence within 15 days of injection.RESULTS:
From 2012 through 2016, a total of 44734 injections were performed in 5318 unique patients. Overall, complication rates were low, representing 1.9% of all injections, with 1031 unique complications in 685 patients (12.9%). The most common minor complications, or those not requiring intervention, were irritation (n = 312) and subconjunctival hemorrhage (n = 284). The most common serious complications, or those requiring intervention, were corneal abrasion (n = 46) and iritis (n = 31). Most complications (66%) were managed adequately by a telephone or Epic (Epic Systems Corp., Verona, WI) electronic message encounter only. Importantly, no injection protocol parameter, such as type of anesthesia, preparation, or post-injection medication, increased the risk of a complication. However, a patient's gender, age, number of previous injections, and provider strongly influenced the risk of patient-reported complications.CONCLUSIONS:
Overall, complication rates seen in routine clinical practice were low compared with clinical trial reporting. Providers should feel confident in the safety and administration of IVI during times when follow-up office visits and resources may be limited. When performing an IVI, factors such as a patient's gender, age, number of previous injections, and provider must be taken into account to ensure the best possible outcomes.Palavras-chave
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Bases de dados:
MEDLINE
Assunto principal:
Doenças Retinianas
/
Acuidade Visual
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Inibidores da Angiogênese
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Medidas de Resultados Relatados pelo Paciente
Tipo de estudo:
Guideline
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Ophthalmol Retina
Ano de publicação:
2021
Tipo de documento:
Article