This is an old revision of the document!

Avastin (bevacizumab) for Retinopathy of Prematurity

Dosing

  • Lowest effective dose is not yet clear
  • Current UIHC dosing
    • Avastin 25mg/ml concentration (undiluted) and giving 0.25 mg in 0.01 ml

Ordering

  • bevacizumab (25mg/ml) 0.25mg per 0.01 ml
  • over fill to 0.11 ml
  • 30 unit Insulin syringe with 31 gauge/ 6mm needle
  • UIHC order set pending
    • Currently (as of 11/25/2020)can be found under “NICU Bevacizumab for intravitreal injection” medication orders
  • UIHC phone numbers
    • NICU Bay 1: 356-1671
    • NICU Pharmacy Office: x85286
    • Children's Hospital Inpatient Pharmacy 356-4300

Procedure

  • Coordinate with NICU staff for procedural sedation
  • Nursing workflow for UIHC PDF

Supplies

  • UIHC Eye Injection Pack
    • Includes plastic cup, cotton-tipped applicators, 4×4 gauze
  • Betadine 5% ampule
  • Tetrcaine or proparacaine drops
  • Lid specula (one per eye if desired)
  • Toothed forceps (0.12, 0.3 or Bishop Harman, one per eye if desired)
  • Sterile gloves
  • Facemask

Suggested Procedure Steps

  1. Tetracaine drops in both eyes
  2. Wipe around eyes and face with 4×4 gauze soaked in betadine
  3. Inspect syringe ensure plunger in proper location to deliver 0.01 ml (waste overfill)
  4. Place lid speculum
  5. Place drops of betadine in eye especially in area for injection with soaked cotton tip applicator
  6. Grasp eye with toothed forceps to stabilize eye
  7. Hold syringe vertically and enter about 1 mm from limbus, aim posteriorly to avoid lens
  8. Slowly depress plunger and then when drug delivered, retract needle
  9. Place new betadine soaked cotton tip applicator over injection site and hold pressure for a few seconds.
  10. Repeat steps 3-9 for fellow eye

Syringe Delivery