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Title: Effect of Needle Type and Injection Technique on Pain Level and Vitreal Reflux in Intravitreal Injection
Authors: Rodrigues, Eduardo B. [UNIFESP]
Grumann, Astor
Penha, Fernando M. [UNIFESP]
Shiroma, Helio
Rossi, Eglas
Meyer, Carsten H. [UNIFESP]
Stefano, Vinicius [UNIFESP]
Maia, Mauricio [UNIFESP]
Magalhaes, Octaviano [UNIFESP]
Farah, Michel E. [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Hosp Reg Sao Jose
Issue Date: 1-Apr-2011
Publisher: Mary Ann Liebert Inc
Citation: Journal of Ocular Pharmacology and Therapeutics. New Rochelle: Mary Ann Liebert Inc, v. 27, n. 2, p. 197-203, 2011.
Abstract: Purpose: To evaluate the amount of reflux and degree of pain with intravitreal injection (IVT) using 6 different types of syringes/needles and 5 techniques of scleral incision, including 3 modifications of a beveled scleral incision.Methods: This was a study conducted in 205 eyes of 205 patients. IVT of bevacizumab for retinal pharmacotherapy with 6 types of needles and 5 techniques of scleral incision. the severity of subjectively evaluated pain (0-10) and the width of the subconjunctival bleb arising from the vitreal reflux. Secondary outcomes were increase in intraocular pressure and complication rate.Results: the straight technique caused greater vitreal reflux than the beveled approaches, when compared individually or as a group (P < 0.01). No difference in the severity of pain was found among all 5 types of incisions (P > 0.05). There was greater reflux with 26- and 27-gauge needles in comparison to 29- and 30-gauge needles (P < 0.001); however, the width of the needle significantly affected the degree of reflux only when using the nonbeveled incision (P < 0.001). the patients injected with the 26- or 27-gauge needle experienced more pain matched to the 29- and 30-gauge needles (P < 0.001). No difference was found between the incision technique or width of subconjunctival reflux and the increase in intraocular pressure (P > 0.05). Postinjection events included transient mild uveitis, disease-related vitreous hemorrhage, foreign body sensation, conjunctival hemorrhage, and mild punctuate keratitis.Conclusions: the beveled scleral incision showed benefit in performing IVTs. the 29- and 30-gauge needles caused less pain.
ISSN: 1080-7683
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Appears in Collections:Em verificação - Geral

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