Intracameral injections are a common and effective ophthalmology procedure. This method delivers medication directly into a specific part of the eye, allowing for precise drug delivery to treat various eye conditions. It is an important tool for eye care professionals.
What Intracameral Injections Are
An intracameral injection administers medication directly into the anterior chamber. This fluid-filled space is located behind the cornea and in front of the iris.
Direct delivery into this space allows for a high concentration of the drug at the target site. This method helps medication bypass the eye’s natural barriers, minimizing systemic side effects as the drug is largely confined to the eye.
Medical Uses of Intracameral Injections
Intracameral injections address various eye conditions. A primary use is during cataract surgery, where antibiotics are injected to prevent endophthalmitis, a severe infection inside the eye. This prophylactic use significantly reduces the risk of such infections.
Beyond infection prevention, these injections also manage inflammation. Dexamethasone, a type of steroid, can be delivered intracamerally to control inflammation following cataract surgery. This helps in the patient’s recovery and can reduce the need for multiple post-operative eye drops. Intracameral steroids can effectively clear anterior chamber inflammation.
Intracameral injections are also employed in treating certain types of glaucoma, particularly neovascular glaucoma. Medications like bevacizumab, an anti-VEGF agent, can be injected into the anterior chamber to reduce abnormal blood vessel growth, which contributes to elevated eye pressure in this condition. This can help lower intraocular pressure and reduce neovascularization. Additionally, some sustained-release implants for glaucoma treatment, containing drugs like bimatoprost, are delivered intracamerally to provide long-term reduction in intraocular pressure.
Furthermore, intracameral injections are used to treat specific eye infections, such as endophthalmitis itself. Antibiotics can be directly injected into the anterior chamber to target the pathogens. They can also be used to address significant inflammation after eye surgery or injury, for example, by injecting tissue plasminogen activator (t-PA) to dissolve fibrin clots.
Receiving an Intracameral Injection
Patients undergoing an intracameral injection can expect a carefully managed process. Before the procedure, numbing eye drops are applied to minimize discomfort. The area around the eye is then cleaned with an antiseptic solution to ensure a sterile environment and reduce the risk of infection. This preparation is similar to what is done for many minor eye procedures.
During the injection, a very fine needle is used to deliver the medication into the anterior chamber. The injection itself is typically quick, often taking only a few seconds. Patients usually do not experience pain due to the numbing medication, but they might feel a brief pressure or a slight burning sensation from the antiseptic. The procedure is generally well-tolerated.
Immediately after the injection, patients might experience temporary blurred vision or mild irritation. It is also common to notice small spots or “floaters” in their field of vision, which are usually small air bubbles that typically disappear within a day. Patients are given specific instructions for post-procedure care, which may include avoiding rubbing the eye and keeping it clean. A temporary increase in eye pressure can occur, but it usually returns to normal quickly.
Outcomes and Important Considerations
Intracameral injections generally achieve favorable outcomes by delivering medication directly to the site of action, leading to effective treatment of various eye conditions. For instance, the use of intracameral antibiotics during cataract surgery has significantly lowered the rate of postoperative infections. Similarly, intracameral steroids can effectively reduce inflammation, leading to improved healing and patient comfort.
While these injections are considered safe, there are some considerations and potential, though rare, side effects. A temporary increase in eye pressure can occur immediately after the injection. Mild irritation, redness, or a feeling of something in the eye are also possible in the short term.
More serious complications are uncommon but can include infection (endophthalmitis), bleeding inside the eye, or, very rarely, retinal detachment. There is also a rare risk of toxic anterior segment syndrome (TASS), a sterile inflammatory reaction caused by a non-infectious substance, which can occur if the medication is not properly prepared or contains certain additives. Ophthalmologists carefully manage these risks through proper technique and sterile procedures. Follow-up appointments are routinely scheduled to monitor the eye’s healing and ensure the treatment’s effectiveness.