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Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections.
Prog Retin Eye Res. 2020 Apr 18 [Online ahead of print]PR

Abstract

Intravitreal injections have become the most commonly performed intraocular treatments worldwide. Because intravitreal injections may induce severe adverse events, such as infectious and noninfectious endophthalmitis, cataract, ocular hypertension, vitreous hemorrhage, or retinal detachment, appropriate awareness of the materials and techniques used are essential to reduce these sight-threatening complications. This review provides insights into the needles, syringes, silicone oil coating, sterilization methods, devices to assist intravitreal injections, scleral piercing techniques using needles, syringe handling, anesthesia, and safety issues related to materials and techniques. It is paramount that physicians be aware of every step involved in intravitreal injections and consider the roles and implications of all materials and techniques used. The ability to understand the theoretical and practical circumstances may definitely lead to state-of-the-art treatments delivered to patients. The most important practical recommendations are: choosing syringes with as little silicone oil as possible, or, preferably, none; avoiding agitation of syringes; awareness that most biologics (e.g., antiangiogenic proteins) are susceptible to changes in molecular properties under some conditions, such as agitation and temperature variation; understanding that improper materials and techniques may lead to complications after intravitreal injections, e.g., inflammation; and recognizing that some devices may contribute to an enhanced, safer, and faster intravitreal injection technique.

Authors+Show Affiliations

Hospital de Olhos de Sergipe, Rua Campo do Brito, 995, Aracaju, SE, Brazil; Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil. Electronic address: gustavobmelo@yahoo.com.br.Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil.Retina Center of Minnesota, 710 E 24th Street, Suite #304, Minneapolis, MN, USA.Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec H1T 2M4, Canada.Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil; Department of Ophthalmology, Philipps University of Marburg, Robert-Koch-Strasse 4, Marburg, Germany.Department of Biotechnology, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Osaka, Japan.Department of Pharmaceutical Sciences, University of Colorado, Denver/Aurora, CO, USA.Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil.Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil.Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil.Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil; Department of Ophthalmology, SSM Health Saint Louis University Hospital, Saint Louis University, 1755, S. Grand Boulevard, Saint Louis, MO, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32311476

Citation

Melo, Gustavo Barreto, et al. "Critical Analysis of Techniques and Materials Used in Devices, Syringes, and Needles Used for Intravitreal Injections." Progress in Retinal and Eye Research, 2020, p. 100862.
Melo GB, Cruz NFSD, Emerson GG, et al. Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections. Prog Retin Eye Res. 2020.
Melo, G. B., Cruz, N. F. S. D., Emerson, G. G., Rezende, F. A., Meyer, C. H., Uchiyama, S., Carpenter, J., Shiroma, H. F., Farah, M. E., Maia, M., & Rodrigues, E. B. (2020). Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections. Progress in Retinal and Eye Research, 100862. https://doi.org/10.1016/j.preteyeres.2020.100862
Melo GB, et al. Critical Analysis of Techniques and Materials Used in Devices, Syringes, and Needles Used for Intravitreal Injections. Prog Retin Eye Res. 2020 Apr 18;100862. PubMed PMID: 32311476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections. AU - Melo,Gustavo Barreto, AU - Cruz,Natasha Ferreira Santos da, AU - Emerson,Geoffrey Guy, AU - Rezende,Flávio Atanázio, AU - Meyer,Carsten H, AU - Uchiyama,Susumu, AU - Carpenter,John, AU - Shiroma,Hélio Francisco, AU - Farah,Michel Eid, AU - Maia,Maurício, AU - Rodrigues,Eduardo Büchele, Y1 - 2020/04/18/ PY - 2020/01/24/received PY - 2020/03/23/revised PY - 2020/04/02/accepted PY - 2020/4/21/pubmed PY - 2020/4/21/medline PY - 2020/4/21/entrez KW - Anesthesia KW - Device KW - Intravitreal injection KW - Needle KW - Silicone oil KW - Syringe SP - 100862 EP - 100862 JF - Progress in retinal and eye research JO - Prog Retin Eye Res N2 - Intravitreal injections have become the most commonly performed intraocular treatments worldwide. Because intravitreal injections may induce severe adverse events, such as infectious and noninfectious endophthalmitis, cataract, ocular hypertension, vitreous hemorrhage, or retinal detachment, appropriate awareness of the materials and techniques used are essential to reduce these sight-threatening complications. This review provides insights into the needles, syringes, silicone oil coating, sterilization methods, devices to assist intravitreal injections, scleral piercing techniques using needles, syringe handling, anesthesia, and safety issues related to materials and techniques. It is paramount that physicians be aware of every step involved in intravitreal injections and consider the roles and implications of all materials and techniques used. The ability to understand the theoretical and practical circumstances may definitely lead to state-of-the-art treatments delivered to patients. The most important practical recommendations are: choosing syringes with as little silicone oil as possible, or, preferably, none; avoiding agitation of syringes; awareness that most biologics (e.g., antiangiogenic proteins) are susceptible to changes in molecular properties under some conditions, such as agitation and temperature variation; understanding that improper materials and techniques may lead to complications after intravitreal injections, e.g., inflammation; and recognizing that some devices may contribute to an enhanced, safer, and faster intravitreal injection technique. SN - 1873-1635 UR - https://www.unboundmedicine.com/medline/citation/32311476/Critical_analysis_of_techniques_and_materials_used_in_devices,_syringes,_and_needles_used_for_intravitreal_injections L2 - https://linkinghub.elsevier.com/retrieve/pii/S1350-9462(20)30034-3 DB - PRIME DP - Unbound Medicine ER -
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