It should be emphasized to the patient that it is absolutely necessary for their safety that they bring the required protective items to their rescheduled visit. The patient should be scheduled for another treatment attempt as soon as possible, but not earlier than 24 hours later from the most recent attempt. If the patient indicates discomfort or pain at or near the infusion site or if any extravasation is noted at any time during the infusion, the infusion should be stopped immediately and cold compresses applied. The extravasation area must be thoroughly protected from bright light until the swelling and discoloration have faded in order to prevent the occurrence of a local burn, which could be severe. Once the patient is home, beginning 24 hours after the event, warm compresses can be used.
Bilateral treatment is addressed in the package insert.
The controlled pivotal trials only allowed treatment of one eye per patient. The package insert instructs that in patients who present for the first time and the physician determines that both eyes are eligible for treatment, the eye with the most aggressive lesion should be treated first. If no severe vision loss occurs from that treatment, the second eye should be treated approximately 1 week later using a separate infusion of Visudyne. If there are no safety problems with either eye, then when retreatment for both eyes in indicated, both eyes can be treated concurrently from one Visudyne infusion. When concurrent treatment takes place, immediately at the end of light application to the first eye, begin treatment on the second eye using the same light dose and intensity.