Reader Question: Avastin vs Lucentis
A reader asks: “From what you've observed in using Avastin® and from the reports from Lucentis® trials are you seeing marked differences in the results of the two products? Perhaps Dr. Folk would comment in his blog. Also, when would one use a "deadener" in the eye as opposed to a topical before the Avastin injection?”
My answer:
Retinal experts have not followed patients who have had Avastin® long enough to determine whether or not the results are similar to Lucentis®. The early results with Avastin have been very good however, so my feeling is that they will be similar to those with Lucentis®.
I have used cotton swabs wet with topical 4% Lidocaine alone to numb the area of injection. About one-third of these patients will feel some pain with the injection. I haven't used Lidocaine® gel to numb the area but would think that the percentage would drop.
I still raise a small subconjunctival bleb of Lidocaine® in most patients in the area of injection. If you wait at least three minutes, only about 10% of these patients will feel anything when the Avastin® is injected. Most of these patients however will have some subconjunctival bleeding after the Lidocaine injection which is harmless but can look bad.
I tend to use topical Lidocaine® only in patients who are on aspirin or Coumadin® because of the subconjuctival bleeding.
-JCF
My answer:
Retinal experts have not followed patients who have had Avastin® long enough to determine whether or not the results are similar to Lucentis®. The early results with Avastin have been very good however, so my feeling is that they will be similar to those with Lucentis®.
I have used cotton swabs wet with topical 4% Lidocaine alone to numb the area of injection. About one-third of these patients will feel some pain with the injection. I haven't used Lidocaine® gel to numb the area but would think that the percentage would drop.
I still raise a small subconjunctival bleb of Lidocaine® in most patients in the area of injection. If you wait at least three minutes, only about 10% of these patients will feel anything when the Avastin® is injected. Most of these patients however will have some subconjunctival bleeding after the Lidocaine injection which is harmless but can look bad.
I tend to use topical Lidocaine® only in patients who are on aspirin or Coumadin® because of the subconjuctival bleeding.
-JCF
posted by James C. Folk, M.D. at 11:15 AM
1 Comments:
Hi Dr Folk,
My mother just had a PDT (visudyne) treatment and her dark area of central vision just doubled after the PDT. Should she switch to Avastin or proceed on the PDT therapy, the second of which is scheduled after 3 months.
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