Short-term complications of intravitreal injections of triamcinolone and bevacizumab

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 20mg triamcinolone acetonide (n = 1588) or 1.5mg 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.