Surgical Retrieval of an Intraocular Needle Following Intravitreal Bevacizumab Injection

2019 ◽  
Vol 3 (4) ◽  
pp. 252-254
Author(s):  
Mariam Mathai ◽  
Joshua D. Levinson ◽  
Aziz A. Khanifar ◽  
Lindsay M. Smithen
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Intravitreal Injection ◽  
Intravitreal Bevacizumab ◽  
Vitreous Cavity ◽  
Surgical Removal ◽  
Intravitreal Bevacizumab Injection ◽  
Initial Injection ◽  
Pars Plana ◽  
23 Gauge

Purpose: The purpose of this case report is to describe a case of iatrogenic intraocular foreign body due to a fractured 30-gauge needle following intravitreal injection of bevacizumab. Methods: A case report is presented. Results: The patient presented with a 30-gauge needle in the vitreous cavity after receiving an intravitreal injection of bevacizumab for diabetic macular edema. Bilateral eye shields were placed to reduce movement of the foreign body and decrease the risk of injury to the lens or retina. The needle was successfully removed via a combination of 23-gauge pars plana vitrectomy and removal of the foreign body via a transscleral approach through the initial injection site. Visual acuity improved to 20/25 2 months after surgery. Conclusions: We present the successful preoperative management and surgical removal of a needle fragment from the vitreous cavity after the needle fractured during intravitreal injection.

Intravitreal Bevacizumab for Proliferative Sickle Retinopathy: A Case Series

2017 ◽  
Vol 2 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Cindy X. Cai ◽  
Marguerite O. Linz ◽  
Adrienne W. Scott
Keyword(s):  
Sickle Cell ◽  
Large Scale ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Beta Thalassemia ◽  
Intravitreal Bevacizumab Injection ◽  
Initial Injection ◽  
Sea Fan ◽  
Recurrent Vitreous Hemorrhage

Purpose: To report outcomes of intravitreal bevacizumab therapy for proliferative sickle retinopathy (PSR). Methods: A retrospective, interventional case series. Five eyes of 5 patients with PSR were managed with intravitreal bevacizumab therapy over a 13-year period at a single institution. Results: Four patients had sickle cell-hemoglobin SC disease and 1 had sickle cell-beta thalassemia disease. Four of the patients treated with intravitreal bevacizumab injection were treated for recurrent vitreous hemorrhage and 1 was treated for new peripheral sea fan neovascularization. In those patients treated for vitreous hemorrhage, there was improvement in visual acuity as early as 2 weeks after treatment. Only 2 of the patients had documented recurrent vitreous hemorrhage during the period of follow-up after the initial injection. In 1 patient, the vitreous hemorrhage did not recur until 13 months after the injection. All patients showed an anatomic response to intravitreal bevacizumab therapy with partial regression of the peripheral sea fan neovascularization. All patients tolerated the injections without any complications. Conclusions: Intravitreal bevacizumab injections appear to be well tolerated and may be an effective treatment of PSR. Regression of peripheral sea fan neovascularization and decreased duration of vitreous hemorrhage may be observed. Large-scale randomized controlled trials are needed to further clarify the role of bevacizumab in PSR.

scholarly journals Acute Endophthalmitis Caused by Leuconostoc spp. following Intravitreal Bevacizumab Injection

2017 ◽  
Vol 8 (3) ◽  
pp. 510-514
Author(s):  
Supreet Singh ◽  
Chirag V. Patel ◽  
Kamal Kishore
Keyword(s):  
Intravitreal Injection ◽  
Intravitreal Bevacizumab ◽  
Outpatient Setting ◽  
Age Related Macular Degeneration ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Intravitreal Bevacizumab Injection ◽  
Persistent Inflammation ◽  
Age Related ◽  
Bevacizumab Injection

We present a case of acute endophthalmitis caused by Leuconostoc spp. following intravitreal bevacizumab injection. An 86-year-old immunocompetent female developed acute endophthalmitis after intravitreal injection of bevacizumab for neovascular age-related macular degeneration. The patient presented with pain, visual acuity of hand motions, hypopyon, and dense vitritis 96 h after treatment. She was treated with vitreous and anterior chamber tap followed by intravitreal injections of 1 mg vancomycin, 2.25 mg ceftazidime, and 400 μg dexamethasone. Cultures revealed growth of Leuconostoc spp., a genus of gram-positive bacteria that is inherently resistant to vancomycin. Due to persistent inflammation, pars plana vitrectomy (PPV) with intravitreal injection of 0.4 mg amikacin was performed 16 days later, followed by resolution of endophthalmitis and return of vision to 20/40. In conclusion, the management of acute endophthalmitis caused by Leuconostoc spp., a gram-positive coccobacillus, can be particularly challenging due to its inherent resistance to vancomycin. PPV with intravitreal amikacin led to resolution of endophthalmitis. Our case expands the number of cases of endophthalmitis caused by Leuconostoc spp. and highlights the possibility of Leuconostoc-related endophthalmitis in an outpatient setting in an immunocompetent host.

scholarly journals Outcome of intravitreal bevacizumab injection without pre and postoperative antibiotics

2020 ◽  
Author(s):  
Ruchi Shrestha ◽  
Pratap Karki ◽  
Sagun Narayan Joshi
Keyword(s):  
Retrospective Study ◽  
Intravitreal Injection ◽  
Treatment Modality ◽  
Intravitreal Bevacizumab ◽  
Prophylactic Antibiotics ◽  
The Other ◽  
Intravitreal Injections ◽  
Intravitreal Bevacizumab Injection ◽  
Retinal Pathologies ◽  
Bevacizumab Injection

Abstract Backgound Intravitreal injections are the most common treatment modality for several retinal pathologies. Despite endophthalmitis being the most feared complication, antibioprophylaxis remains controversial in intravitreal injections.Methods This was a retrospective study done for a period of 2 years from 1st January 2017 to 31st December 2018 in BPKLCOS among patients receiving intravitreal bevacizumab. The intravitreal injection was given by a single surgeon. It included 503 eyes which received intravitreal bevacizumab over a period of 2 years without pre and postoperative antibiotics.Results Out of 503 eyes studied over a period of 2 years without antibiotic prophylaxis the rate of endophthalmitis was 0.0019% which is very low compared to the other studies with rate of endophthalmitis between 0.019-0.09%.Conclusion The rate of endophthalmitis doesn’t increase after giving intravitreal injections without the use of preoperative/postoperative prophylactic antibiotics. Intravitreal injection can be given safely without pre-operative and post-operative antibiotics. Trial Registration not applicable as it is a retrospective study.

scholarly journals Intraoperative Macula Protection by Perfluorocarbon Liquid for the Metallic Intraocular Foreign Body Removal during 23-Gauge Vitrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Robert Rejdak ◽  
Tomasz Choragiewicz ◽  
Joanna Moneta-Wielgos ◽  
Dominika Wrzesinska ◽  
Dorota Borowicz ◽  
...  
Keyword(s):  
Foreign Body ◽  
Intraocular Foreign Body ◽  
Perfluorocarbon Liquid ◽  
Foreign Body Removal ◽  
Corrected Distance Visual Acuity ◽  
Iatrogenic Lesion ◽  
Pars Plana ◽  
The Mean ◽  
23 Gauge

Purpose.To evaluate visual and safety outcomes of 23-gauge (G) pars plana vitrectomy (PPV) with application of perfluorocarbon liquid (PFCL) for intraoperative protection of the macula during intraocular foreign body (IOFB) removal.Methods.Retrospective study of 42 patients who underwent 23 G PPV for IOFB removal from posterior segment with intraoperative PFCL application for the macula shielding. Collected data included corrected distance visual acuity (CDVA), size of IOFB, and complication rate. The mean follow-up period was 12 months.Results. The mean preoperative CDVA was 0.54 logMAR (SD 0.46), and the final mean CDVA was 0.68 logMAR (SD 0.66). All IOFBs were metallic with mean dimensions of 4.6 mm × 2.1 mm. Twenty-two IOFBs were removed through the corneal tunnel and 20 IOFBs through the sclerotomy. No intraoperative iatrogenic lesion of the macula was observed. As a tamponade, silicon oil was applied in 31 eyes, SF6gas in 5 eyes, air in 4 eyes, and 2 eyes required no tamponade. Secondary retinal detachment was observed in 17% of cases, but at the end of the follow-up, all the retinas were attached.Conclusion. PFCL application during PPV is a safe method of protecting the macula from unexpected falling of the metallic IOFB during its removal.

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