Retinal Physician Supplement

Injection Technique Update 2017

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as you want so you can practice. For experienced vitreoretinal surgeons, the learning curve is really very short. To me, it's actually more simple to inject an OZURDEX® (dexamethasone intravitreal implant) implant than it is to insert a cannula with a trocar during surgery. As Dr. Hariprasad mentioned, I advise doctors to "own the injection." When you execute with confidence, you have an ease and rapidity of motion that makes for a good experience for the patient and for yourself. Dr. Drenser: It's helpful for residents or fellows to gain experience injecting OZURDEX® in the wet lab setting to increase comfort level when subsequently injecting OZURDEX® into an anesthetized eye. Dr. Saran: e key is to think of the OZURDEX® injection technique as one fluid motion rather than several isolated steps. You have to commit, choose your site, do the entry, and then press the applicator button in one swi motion. at limits the amount of contact time with the eye and increases patient cooperation. I gently squeeze the trigger, which allows for a controlled injection. Patients can perceive your confidence, and the procedure is smooth and seamless. Dr. Almeida: I've seen beginners who aren't accustomed to using trocars get hung up on trying to bevel the incision. Dr. Hariprasad: It is sensible for inexperienced injectors, or even experienced surgeons who want to try delivering the implant before performing the procedure on a patient, to take advantage of the opportunity to practice with an Allergan OZURDEX® (dexamethasone intravitreal implant) 0.7 mg wet lab. Also, it's worth reiterating the importance of approaching the injection with confidence and using a fluid motion. With proper training and experience, it's a simple procedure, and it's not necessary to overcomplicate it. Meeting an Important Need in Patient Care Dr. Hariprasad: Let's close with thoughts on the dexamethasone intravitreal implant and its importance in the treatment algorithms for DME and macular edema following BRVO or CRVO. Dr. Garg: I'm delighted to have this treatment to offer my patients. It expands how well I can treat them. e more we learn about it, the more we find that it's a great option to have. Dr. Drenser: I've found that OZURDEX® can be effective for many patients. 12 I have a growing number of OZURDEX® patients who have their visual acuity managed effectively without the need for monthly injections. I've steadily increased my use of OZURDEX®. Its use is straightforward. Also, it is helpful to have the second-generation needle and all of the support from Allergan regarding patient assistance. Dr. Saran: My primary impression of the dexamethasone intravitreal implant is that it fills an important need. OZURDEX® helps treat the inflammatory component of DME without the need for monthly injections. Dr. Almeida: OZURDEX® produces good visual improvements, OZURDEX® UPDATE 11 Please see additional Important Safety Information on the following pages. IMPORTANT SAFETY INFORMATION (continued) Adverse Reactions (continued) Retinal Vein Occlusion and Posterior Segment Uveitis (continued) Increased IOP with OZURDEX ® (dexamethasone intravitreal implant) peaked at approximately week 8. During the initial treatment period, 1% (3/421) of the patients who received OZURDEX ® required surgical procedures for management of elevated IOP. "Using the second-generation needle is smooth. There's very little resistance entering the eye." — BRUCE SARAN, MD

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