First Author: I.Ioshin RUSSIA
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Intravitreal anti-VEGF injections are the most common intraocular procedure in ophthalmology. The technology is simple and safe, intraoperative complications are very rare, so the tactics of handling such patients are discussed.
Federal State Institute “Clinical Hospital’, Moscow, Russia
A 64-year-old patient with a diagnosis of wet AMD received Intravitreal anti-VEGF injections throughout a year. Visual acuity before last injection was 20/50. Last injection was performed under standard conditions - in the operating room, under local anaesthesia with medial mydriasis, 3.5 mm from the limbus (eye length 23.41 mm) in the pars plana projection in the lower-external segment with a 27 G needle.
A decrease in vision (20/100) and the appearance of fog were observed the next day after the injection. There were a linear damage to the posterior capsule and a posterior subcapsular opacification of the lens at a slit lamp examination. The patient underwent phacoemulsification of iatrogenic cataract with intraocapsular IOL implantation. Features of surgery - the absence of hydrodelineation and of hydrodissection, low aspiration (25 mm Hg), vacuum (300 Hg), ultrasound (20%), irrigation (60 cm). Aspiration of residual lens masses was carried out in a viscoelastic space (dry technique). The operation was successful. The visual acuity increased to 20/30
Phacoemulsification of the lens capsule damage after intravitreal injections can be successfully achieved while maintaining the least traumatic elements of the operation.