Anti-vascular endothelial growth factor (VEGF) injections are preserving vision for patients with a variety of conditions who would have had few treatment options prior to their advent. But they’re not perfect. Like any medication—especially one that requires invasive intraocular injections for delivery—they carry a few risks, such as retinal pigment epithelium tears, vitreoretinal fibrosis, secondary glaucoma, retinal detachment and endophthalmitis.1 So, it may seem prudent to tread lightly when using this therapy. However, according to a new retrospective study, injecting both eyes in one day doesn’t really increase the risk of complications.

A Canada-based research team looked at 524 eyes of 262 patients who received concomitant bilateral intravitreal anti-VEGF injections in 2016. If any of the patients were receiving simultaneous bilateral injections on a regular basis prior to 2016, data pertaining to previous injections were also reviewed. The researchers found that the patients underwent an average of 19 bilateral injection sessions. In a total of 9,798 shots, incidence of endophthalmitis was 0.01%, and only two episodes of acute intraocular inflammation were seen.

 “Same-day bilateral intravitreal anti-VEGF injections present a low rate of complications and are well tolerated by patients,” the study concludes. “This safe practice may reduce the burden on the health-care system and on the patients.”

1. Falavarjani K, Nguyen Q. Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature. Eye (Lond). 2013;27(7):787-94.

2. Juncal V, Francisconi C, Altomare F, et al. Same-day bilateral intravitreal anti-vascular endothelial growth factor injections: experience of a large Canadian retina center. Ophthalmologica. March 29, 2019. [Epub ahead of print].