Comparison of Two Different Intravitreal Injection Techniques

Harvey S Uy, Jose Carlo M Artiaga, Harvey S Uy, Jose Carlo M Artiaga

Abstract

Objective: To compare the effectiveness, procedure time and safety outcomes of two different intravitreal injections (IVI) techniques.

Methods: This was a prospective, single-center, randomized clinical trial of 200 adult eyes receiving intravitreal medications for various indications. Eyes were assigned (1:1) to undergo IVI using either an intravitreal injection guide (IIG) (n= 100) or conventional dual blade speculum plus surgical caliper (DBS) (n=100). All IVI were administered using a 30-gauge needle placed 4 mm posterior to the inferior limbus. The main outcome measures were rate of successful IVI administration, procedure time (seconds) as measured by a stopwatch from application to removal of IIG or DBS, patient preference for IVI technique and adverse events.

Results: The two groups were similar in terms of mean age (P=0.398), laterality (P=0.671), indication for treatment (P=0.175) and medication type (P=0.489). All IVI procedures were successfully completed in both groups. The mean procedure time was shorter using the IIG (9.94 ± 2.87 seconds) versus DBS (21.85 ± 7.25 seconds) technique (P ≤ 0.01). The incidence of post-injection subconjunctival hemorrhage was higher when the DBS was applied (OR = 2.35, 95% CI = 1.22-4.53). Patients with previous history of IVI preferred the IIG over the DBS. No other injection-related adverse events were observed in both groups.

Conclusion: DBS and IIG techniques are similarly effective and safe for the administration of intravitreal medications. The IIG appears to significantly reduce procedure time, be associated with a lower incidence of subconjunctival hemorrhage and engender better patient acceptance.

Clinical trial registration: ClinicalTrials.gov (NCT04455399).

Keywords: aflibercept; anti-vascular endothelial growth factor; bevacizumab; intravitreal injection; intravitreal injection guide; ranibizumab.

Conflict of interest statement

The authors report no conflicts of interest in this work.

© 2021 Uy and Artiaga.

Figures

Figure 1
Figure 1
Photograph of Malosa Intravitreal Injection Guide demonstrating (1) lash guard, (2) curved triangular footplate, (3) cylindrical injection chamber, (4) wishbone handle.
Figure 2
Figure 2
Operating microscope view of 30-gauge needle being inserted through: (A) injection chamber of the Malosa Intravitreal Injection Guide with the surgical field exposed by single blade lid speculum, and (B) the pars plana with surgical field exposed by solid dual blade lid speculum.

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Source: PubMed

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