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The JAMA recently published a report, saying that Lucentis injection is non inferior to laser (PRP) in Proliferative Diabetic Retinopathy.
The disadvantage of laser is that it causes loss of side (peripheral) vision, and dark adaptation. Its advantage is that its effects are more permanent than Lucentis. The disadvantage of Lucentis in this study is that it stays in the eye only for about 4-6 weeks, hence, the new vessels which causes hemorrhage can grow back again and cause rebleeding. Hence multiple injections are needed and follow up is needed for long periods of time.
The advantage of Lucentis is there no loss of side vision or dark adaptation. Of course the issue of cost is another important issue here in our country, where most of health care is out of your own pocket, unlike the insurance system in most developed countries.
For me, I would use it only if patient has coexisting swelling of the macula (diabetic macular edema). Otherwise, I still recommend laser for most of my patients.