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Release of silicone oil and the off-label use of syringes in ophthalmology.
Br J Ophthalmol. 2020 02; 104(2):291-296.BJ

Abstract

BACKGROUND/AIMS

To assess silicone oil (SO) release by different brands of syringes used for intravitreal injection under different handling conditions.

METHODS

Eight syringes were analysed: from the USA, Terumo 0.5 mL, Becton-Dickinson (BD) Tuberculin 1 mL, BD Luer-lok 1 mL, BD Ultra-Fine 0.3 mL and Exel Insulin 0.3 mL; from Germany, Braun Omnifix-F 1 mL and Braun Injekt-F 1 mL and from Spain, BD Plastipak 1 mL. The impact of air, priming the plunger, agitation by flicking and fluid temperature on SO release were assessed by light microscopy. Fourier transform infrared spectroscopy (FTIR) was performed to identify the molecular compound in each syringe.

RESULTS

Five hundred and sixty syringes were analysed. Terumo 0.5 mL and BD Ultra-Fine 0.3 mL released more SO than all others. BD Luer-lok 1 mL, BD Plastipak and Braun Omnifix-F 1 mL released little SO; BD Tuberculin 1 mL, Exel 0.3 mL and Braun Injekt-F 1 mL released the least SO. Priming the syringe and different temperatures did not significantly affect SO release. Agitation by flicking caused a significantly higher proportion of samples to have SO droplets and an increased number of oil droplets. Air had an additive effect on the release of oil in the agitation groups. FTIR identified polysiloxane in all syringes but Injekt-F.

CONCLUSION

Syringes commonly used for intravitreal injections frequently release SO droplets, especially when agitated by flicking. To avoid unnecessary ocular risks, syringes should not be agitated before intravitreal injection. It is desirable that syringes be manufactured specifically for ophthalmic use.

Authors+Show Affiliations

Hospital de Olhos de Sergipe, Aracaju, Brazil gustavobmelo@yahoo.com.br. Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.Retina Center of Minnesota, Minneapolis, Minnesota, USA.Hospital de Olhos de Sergipe, Aracaju, Brazil.Hospital de Olhos de Sergipe, Aracaju, Brazil. Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. Vision Institute, IPEPO, São Paulo, Brazil.Chemical Analysis Laboratory, Center for Chemistry and Manufactured Goods, Institute for Technological Research, São Paulo, Brazil.Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. Vision Institute, IPEPO, São Paulo, Brazil.Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. Vision Institute, IPEPO, São Paulo, Brazil.Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. Vision Institute, IPEPO, São Paulo, Brazil.Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. Vision Institute, IPEPO, São Paulo, Brazil.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30910872

Citation

Melo, Gustavo Barreto, et al. "Release of Silicone Oil and the Off-label Use of Syringes in Ophthalmology." The British Journal of Ophthalmology, vol. 104, no. 2, 2020, pp. 291-296.
Melo GB, Emerson GG, Dias CS, et al. Release of silicone oil and the off-label use of syringes in ophthalmology. Br J Ophthalmol. 2020;104(2):291-296.
Melo, G. B., Emerson, G. G., Dias, C. S., Morais, F. B., Lima Filho, A. S., Ota, S., Farah, M. E., Rodrigues, E. B., Maia, M., & Belfort, R. (2020). Release of silicone oil and the off-label use of syringes in ophthalmology. The British Journal of Ophthalmology, 104(2), 291-296. https://doi.org/10.1136/bjophthalmol-2019-313823
Melo GB, et al. Release of Silicone Oil and the Off-label Use of Syringes in Ophthalmology. Br J Ophthalmol. 2020;104(2):291-296. PubMed PMID: 30910872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Release of silicone oil and the off-label use of syringes in ophthalmology. AU - Melo,Gustavo Barreto, AU - Emerson,Geoffrey Guy, AU - Dias,Celso Souza,Jr AU - Morais,Fábio Barreto, AU - Lima Filho,Acacio de Souza, AU - Ota,Shoko, AU - Farah,Michel Eid, AU - Rodrigues,Eduardo Büchele, AU - Maia,Maurício, AU - Belfort,Rubens,Jr Y1 - 2019/03/25/ PY - 2019/01/01/received PY - 2019/02/14/revised PY - 2019/02/26/accepted PY - 2019/3/27/pubmed PY - 2020/7/18/medline PY - 2019/3/27/entrez KW - intravitreal injection KW - silicone oil droplets KW - syringe SP - 291 EP - 296 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 104 IS - 2 N2 - BACKGROUND/AIMS: To assess silicone oil (SO) release by different brands of syringes used for intravitreal injection under different handling conditions. METHODS: Eight syringes were analysed: from the USA, Terumo 0.5 mL, Becton-Dickinson (BD) Tuberculin 1 mL, BD Luer-lok 1 mL, BD Ultra-Fine 0.3 mL and Exel Insulin 0.3 mL; from Germany, Braun Omnifix-F 1 mL and Braun Injekt-F 1 mL and from Spain, BD Plastipak 1 mL. The impact of air, priming the plunger, agitation by flicking and fluid temperature on SO release were assessed by light microscopy. Fourier transform infrared spectroscopy (FTIR) was performed to identify the molecular compound in each syringe. RESULTS: Five hundred and sixty syringes were analysed. Terumo 0.5 mL and BD Ultra-Fine 0.3 mL released more SO than all others. BD Luer-lok 1 mL, BD Plastipak and Braun Omnifix-F 1 mL released little SO; BD Tuberculin 1 mL, Exel 0.3 mL and Braun Injekt-F 1 mL released the least SO. Priming the syringe and different temperatures did not significantly affect SO release. Agitation by flicking caused a significantly higher proportion of samples to have SO droplets and an increased number of oil droplets. Air had an additive effect on the release of oil in the agitation groups. FTIR identified polysiloxane in all syringes but Injekt-F. CONCLUSION: Syringes commonly used for intravitreal injections frequently release SO droplets, especially when agitated by flicking. To avoid unnecessary ocular risks, syringes should not be agitated before intravitreal injection. It is desirable that syringes be manufactured specifically for ophthalmic use. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/30910872/Release_of_silicone_oil_and_the_off_label_use_of_syringes_in_ophthalmology_ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&pmid=30910872 DB - PRIME DP - Unbound Medicine ER -