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Segal O, Segal-Trivitz Y, Nemet AY, et al. Survey of intravitreal injection techniques among retina specialists in Israel. Clin Ophthalmol. 2016;10:1111-6doi: 10.2147/OPTH.S96452.
Segal, O., Segal-Trivitz, Y., Nemet, A. Y., Geffen, N., Nesher, R., & Mimouni, M. (2016). Survey of intravitreal injection techniques among retina specialists in Israel. Clinical ophthalmology (Auckland, N.Z.), 101111-6. https://doi.org/10.2147/OPTH.S96452
Segal, Ori, et al. "Survey of intravitreal injection techniques among retina specialists in Israel." Clinical ophthalmology (Auckland, N.Z.) vol. 10 (2016): 1111-6. doi: https://doi.org/10.2147/OPTH.S96452
Segal O, Segal-Trivitz Y, Nemet AY, Geffen N, Nesher R, Mimouni M. Survey of intravitreal injection techniques among retina specialists in Israel. Clin Ophthalmol. 2016 Jun 14;10:1111-6. doi: 10.2147/OPTH.S96452. eCollection 2016. PMID: 27366050; PMCID: PMC4913990.
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Clin Ophthalmol. 2016 Jun 14;10:1111-6. doi: 10.2147/OPTH.S96452. eCollection 2016.

Survey of intravitreal injection techniques among retina specialists in Israel.

Clinical ophthalmology (Auckland, N.Z.)

Ori Segal, Yael Segal-Trivitz, Arie Y Nemet, Noa Geffen, Ronit Nesher, Michael Mimouni

Affiliations

  1. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  2. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; Department of Psychiatry, Geha Psychiatric Hospital, Petah Tikva, Israel.
  3. Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.

PMID: 27366050 PMCID: PMC4913990 DOI: 10.2147/OPTH.S96452

Abstract

PURPOSE: The purpose of this study was to describe antivascular endothelial growth factor intravitreal injection techniques of retinal specialists in order to establish a cornerstone for future practice guidelines.

METHODS: All members of the Israeli Retina Society were contacted by email to complete an anonymous, 19-question, Internet-based survey regarding their intravitreal injection techniques.

RESULTS: Overall, 66% (52/79) completed the survey. Most (98%) do not instruct patients to discontinue anticoagulant therapy and 92% prescribe treatment for patients in the waiting room. Three quarters wear sterile gloves and prepare the patient in the supine position. A majority (71%) use sterile surgical draping. All respondents apply topical analgesics and a majority (69%) measure the distance from the limbus to the injection site. A minority (21%) displace the conjunctiva prior to injection. A majority of the survey participants use a 30-gauge needle and the most common quadrant for injection is superotemporal (33%). Less than half routinely assess postinjection optic nerve perfusion (44%). A majority (92%) apply prophylactic antibiotics immediately after the injection.

CONCLUSION: The majority of retina specialists perform intravitreal injections similarly. However, a relatively large minority performs this procedure differently. Due to the extremely low percentage of complications, it seems as though such differences do not increase the risk. However, more evidence-based medicine, a cornerstone for practice guidelines, is required in order to identify the intravitreal injection techniques that combine safety and efficacy while causing as little discomfort to the patients as possible.

Keywords: injection; intravitreal; patterns; practices; retina; techniques

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