Name of the Procedure:

Injection, pegaptanib sodium, 0.3 mg (J2503)
Common name(s): Macugen injection
Technical/medical term(s): Intravitreal injection of pegaptanib sodium

Summary

Pegaptanib sodium, commonly known as Macugen, is a medication injected directly into the eye to treat certain eye conditions. The procedure involves a healthcare professional administering a small dose of the medicine to help manage and improve vision.

Purpose

Medical Conditions or Problems it Addresses:

• Age-related macular degeneration (AMD)
• Diabetic macular edema (DME)

Goals or Expected Outcomes:

• To slow the progression of macular degeneration
• To prevent further vision loss
• To improve vision clarity and quality of life

Indications

Specific Symptoms or Conditions:

• Blurred or distorted central vision
• Swelling of the macula due to diabetes
• Leakage or bleeding in the eye affecting vision

Patient Criteria:

• Diagnosed with neovascular (wet) AMD or DME
• Suitable for intravitreal injections as determined by an ophthalmologist

Preparation

Pre-Procedure Instructions:

• No specific fasting required
• Continue taking prescribed medications unless advised otherwise
• Arrange for transportation post-procedure, as vision may be temporarily affected

Diagnostic Tests or Assessments:

• Comprehensive eye examination
• Optical coherence tomography (OCT) to assess the retina
• Fluorescein angiography to evaluate blood vessels in the eye

Procedure Description

Step-by-Step Explanation:

1. Eye is numbed with anesthetic drops.
2. Eye and surrounding area are cleaned to prevent infection.
3. A sterile eyelid speculum may be used to keep the eye open.
4. Pegaptanib sodium is injected into the vitreous gel of the eye using a fine needle.
5. The eye is possibly rinsed with a saline solution.
6. Post-injection intraocular pressure may be monitored.

Tools/Equipment Used:

• Anesthetic eye drops
• Sterile gloves and instruments
• Fine needle syringe

Anesthesia or Sedation:

• Local anesthesia (eye drops)

Duration

The injection procedure typically takes about 10 to 15 minutes.

Setting

This procedure is usually performed in an outpatient clinic or an eye specialist's office.

Personnel

Healthcare Professionals Involved:

• Ophthalmologist (eye surgeon)
• Ophthalmic nurse or assistant

Risks and Complications

Common Risks:

• Mild eye discomfort or redness
• Temporary blurring of vision
• Slight bleeding at the injection site

Rare Risks:

• Endophthalmitis (serious eye infection)
• Retinal detachment
• Increased intraocular pressure

Complications Management:

• Prompt treatment with antibiotics for infections
• Surgical intervention for serious complications, if necessary

Benefits

Expected Benefits:

• Stabilization or improvement of vision
• Reduction in the progression of AMD or DME How Soon Benefits Might be Realized:
• Some improvement may be noticed within a few weeks, with continuous benefit over several months.

Recovery

Post-Procedure Care:

• Use prescribed antibiotic or anti-inflammatory eye drops
• Avoid rubbing or pressing on the eye
• Wear an eye patch if advised by the doctor

Expected Recovery Time:

• Most patients recover within a few days
• Follow-up appointments to monitor progress may be scheduled

Restrictions:

• Temporary restriction on activities requiring clear vision, such as driving

Alternatives

Other Treatment Options:

• Laser therapy
• Photodynamic therapy
• Other anti-VEGF injections (e.g., ranibizumab, aflibercept)

Pros and Cons:

• Laser therapy is less effective for some patients
• Other injections may have different efficacy and side effect profiles

Patient Experience

During the Procedure:

• Minimal pain due to local anesthesia
• Mild pressure sensation when injection is administered

After the Procedure:

• Mild discomfort or grittiness in the eye for a day or two
• Vision might be blurry temporarily

Pain Management and Comfort Measures:

• Over-the-counter pain relievers if necessary
• Use of prescribed soothing eye drops