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Your macula sits at the back of your eye, and it's largely responsible for your sight. The sensitive tissue relies on a deep network of nourishing blood vessels.
Sometimes, the body grows too many of them, and they weaken and bleed. That condition is known as wet macular degeneration (AMD). Lucentis is made to treat it.
Lucentis blocks your body's ability to create too many eye blood vessels. It's delivered via injection into the eye, and some people need up to 12 of these shots every year.
During a Lucentis treatment, your doctor numbs your eye and props it open (so a blink can't ruin the procedure). Your eye should not hurt, but you may experience some pressure. Common side effects include red eyes, nausea, and speckles in your vision.
Lucentis is not the only medication available to treat wet AMD. Other drugs are very similar, and they perform just as well in studies. Some are quite a bit less expensive, although they come with unique risks.
If Lucentis does not work for your wet AMD, your doctor may try a different approach. Switching to a new drug, or adding laser therapy, may be helpful.
What Is Lucentis?
Your body relies on chemical signals to trigger blood vessel development. When those signals are present, the body starts building. When they are not, the body rests. Lucentis works on those chemicals, so your body produces fewer damaged vessels behind your macula.
Your body's chemical signal is known as vascular endothelial growth factor (VEGF). Lucentis is an anti-VEGF medication. While it's mainly used to treat wet AMD, the American Academy of Ophthalmology says this medication can be used to treat other eye health issues, including:
- Diabetic retinopathy.
- Macular edema.
- Retinal vein occlusion.
Lucentis is delivered by needle into the center of your eye. It's effective while it's in place, but as experts point out, it does wear off. Some patients need up to 12 eye injections every year to keep wet AMD under control.
How Treatment With Lucentis Works
Since Lucentis is delivered with a needle into your eye, you can't take the drug at home. You will need the help of a doctor for each treatment. But the injections can be performed in a doctor's office in just a few minutes.
The BrightFocus Foundation says people who need Lucentis treatments move through these steps:
- Examination: Your doctor will dilate your eyes and assess the health of your macula, optic nerve, and other vital structures.
- Preparation: Your doctor will use drops to numb your eyes, and then your eye will be cleaned with iodine. An eyelid holder will keep you from blinking at the wrong time.
- Injection: You will look up, and your doctor will use a tiny needle to put the medication inside your eye.
- Recovery: Your eye may be sore, but Tylenol or a similar medication can help. You may need to use antibiotic drops for a few days.
The manufacturer of Lucentis says that some people have serious side effects due to the injection, such as infection, detached retina, and cataract. The most common side effects are pain, eye redness, and flecks in your vision. If you are not sure if your discomfort or unusual symptoms are caused by the injection or something else, call your doctor.
While injections and side effects sound scary, do not forget that wet AMD can cause blindness. Treatment is critical, and medications like Lucentis can help. The American Academy of Ophthalmology says, for example, that 9 people in 10 treated with anti-VEGF drugs have stable vision, and one in three people have improved vision.
Other Options to Try
There is no doubt that Lucentis is a remarkable medication. But it's not the only drug in the anti-VEGF class. For some people, other medications are more effective and reasonable to use.
The American Academy of Ophthalmology reports that there are three similar medications doctors can use to treat wet AMD, including:
- Lucentis. This drug has been FDA-approved for use in the eye to treat wet AMD and other optical issues.
- Eylea. This medication has also been approved by the FDA for optical use.
- Avastin. This medication was developed as a colon cancer treatment, but some doctors use it to treat eye issues. It has not been approved by the FDA for this purpose.
Cost separates these three medications. The American Academy of Ophthalmology points out that Lucentis and Eylea come to doctors packaged in one single-serving needle for injection, and they both cost about $2,000 per treatment. Avastin comes in a bottle, and it must be compounded or separated into eye doses. Injections cost about $50 each.
Research from 2011 suggests that there is no appreciable difference in outcomes in people who get Avastin and Lucentis injections. Both sets of patients got better when the injections were completed.
But some concerns remain about Avastin. As Harvard Medical School points out, people can and do develop eye infections after using Avastin, and some have lost their sight as a result. Very cautious doctors might prefer to use the more expensive medications to ensure that this tragic problem does not happen to their patients.
Sometimes, patients are asked to choose. Experts say that insurance plans like Medicare cover all of these medications, so doctors and patients have power. But patients limited by high copayments and minimal coverage might be asked to pick up some or all of the cost differences, should they demand a more expensive medication. For some patients, that is not ideal.
What Else Can You Try?
We've mentioned that plenty of people who have Lucentis injections benefit from them. But some people have persistent cases of wet AMD that don’t respond to standard forms of treatment.
- Switching medications. If Lucentis does not work on your eyes, perhaps another anti-VEGF drug would work a little better.
- Higher doses. Your doctor may need to give you more of the active ingredient in each injection to help transform your eye.
- Altered schedules. Most patients have injections every four weeks. Your doctor may need to treat your eyes every two weeks.
- Light or laser therapy. A surgical procedure can help your doctor to eliminate unusual blood vessels, so your eyes can heal.
Your doctor can explain your choices to you and help you understand the best path forward.
Anti-VEGF Treatments. (March 2019). American Academy of Ophthalmology.
One Blockbuster Drug Explains a Lot About Our Out-of-Control Healthcare Costs. (June 2014). Business Insider.
Injections for Wet Macular Degeneration: What to Expect. (December 2019). BrightFocus Foundation.
Anti-VEGF Treatments. (March 2019). American Academy of Ophthalmology.
Avastin, Eylea, and Lucentis: What's the Difference? (July 2015). American Academy of Ophthalmology.
Avastin and Lucentis Are Equivalent in Treating Age-Related Macular Degeneration. (April 2012). National Institutes of Health.
Ask the Doctor: For Macular Degeneration, Which Is Better, Avastin or Lucentis? (December 2011). Harvard Medical School.
Why Do Doctors Choose a $2,000 Cure When a $50 One Is Just as Good? (December 2015). Chicago Tribune.
Wet AMD: When Your First-Line Fails. (August 2018). Review of Ophthalmology.