The intravitreal injections, used in the treatment of maculopathies, leave the operating room: they will be administered in the dedicated surgical clinic, the first in Italy, at the ophthalmology clinic of the S. Maria della Misericordia hospital in Perugia. Which will thus be able to administer it 5 thousand a year guaranteeing very high levels of safety, increasing the possibility of access to treatment, reducing waiting times and ensuring continuity of care throughout the entire therapeutic process. “In recent years we have observed a constant increase in the number of intravitreal injections carried out, equal to approximately 20% per year – he states Carlo Cagini, director of the Perugia clinic – this forced us to have a periodic discussion with the health management, in order to guarantee adequate treatment for all patients”.
Among the maculopathies, Age-related macular degeneration (AMD) is the leading cause of vision loss in industrialized countries globally. In Italy it is estimated that more than 500 thousand people are affected and approximately 50 thousand new cases are recorded every year. The treatment of maculopathies – explains a note – has significantly improved in recent years, with the introduction of anti-VEGF drugs (administered via intravitreal injections), which have proven effective in stabilizing or even improving visual acuity, as well as quality of life of patients. This approach has brought significant improvements to the visual prognosis of many patients, but the large number of treatments carried out has forced ophthalmology services to implement a profound reorganization of the services offered.
The regulations governing the administration of intravitreal injections differ depending on the countries where they are practiced. In Italy the limit was represented by the fact that the only environment authorized for this type of procedure was the operating room. Cumbersome, expensive environment, the intensive use of which hinders the access of patients who must undergo other real eye surgery (cataracts, transplants, retinal detachments…). The Covid-19 pandemic has resulted in a further reduction in the availability of administration in the operating room, further highlighting the problem. To meet this therapeutic request, as intravitreal procedures are non-elective therapies, the Soi (Italian Ophthalmological Society) has opened up the possibility of carrying out administrations in surgical clinics.
“It was necessary to leave the operating room – explains Cagini – creating clean rooms (as already happens in the countries of the Anglo-Saxon world for this type of low-complexity interventions), i.e. simple clinics that can be equipped with ‘laminar flow’ hoods in order to allow work in safe conditions”. The principle therefore is to “ensure compliance with therapeutic times, while maintaining maximum levels of safety. Our surgical clinic – he adds – is equipped, in fact, with a focused laminar flow generator, capable of eliminating 99.9% of airborne bacteria and microorganisms within the clinic itself, creating an environment that is not inferior in terms of safety, to that of the operating room”.
“The new outpatient path has increased patient comfort – he declares Giuseppe De Filippis, general director of the S. Maria della Misericordia hospital in Perugia – This process has numerous advantages. First of all, access to treatment is much quicker, because patient preparation is simpler, as is access to clinics, avoiding unnecessary hospital stays. Furthermore, operating rooms are made available for more complex surgeries and healthcare personnel can also be assigned to other types of operations. An integrated multi-professional team – continues De Filippis – therefore accompanies the patient from the pre-operative visit to the follow-up, passing through the administration of the drug, with scheduled visits in which the patient is re-evaluated, both through functional and morphological studies , to highlight the changes in the clinical picture following therapeutic injections. All this – he concludes – falls within the concept of ‘one stop clinic‘: a single healthcare facility, which fully manages the patient’s pathology, guaranteeing continuity of care”.
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