Survey of Intravitreal Injection Techniques Among Retinal Specialists in the United States

• Published in: American journal of ophthalmology Vol. 151; no. 2; pp. 329 - 332
• Main Authors: Green-Simms, Amy E, Ekdawi, Noha S, Bakri, Sophie J
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2011; Elsevier; Elsevier Limited
• Subjects: Academies and Institutes; Biological and medical sciences; Health Care Surveys - statistics & numerical data; Humans; Intravitreal Injections - statistics & numerical data; Medical sciences; Miscellaneous; Needles - statistics & numerical data; Ophthalmology; Ophthalmology - education; Ophthalmology - statistics & numerical data; Practice Patterns, Physicians' - statistics & numerical data; Retina; Specialization; Surveys and Questionnaires; United States; Visual Acuity - physiology; United States; North America; America; Survey; Surveillance; Vitreous body; Retina; Injection; Ophthalmology; Technique
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2010.08.039

Purpose To describe the intravitreal injection technique practice patterns of retinal specialists in the United States from April 8, 2010 to April 21, 2010. Design Questionnaire survey. Methods All members of the American Academy of Ophthalmology who self-categorized as “Retinal/Vitreous Surgery” were contacted by e-mail to complete an anonymous, 20-question, internet-based survey. Results A total of 765 retinal specialists (44%) responded to the survey. Most respondents wear gloves (58%) and use an eyelid speculum (92%) when performing an intravitreal injection. More than 99% use povidone-iodine preinjection. The majority measure the injection site from the limbus (56%) and inject straight into the vitreous cavity (96%). Most do not displace the conjunctiva (83%). Seventy-two percent routinely assess postinjection optic nerve perfusion, primarily by gross visual acuity measurement (32%). While nearly one third of participants use prophylactic topical antibiotics preinjection, more than two thirds use topical antibiotics postinjection. Forty-six percent perform bilateral simultaneous intravitreal injections. The majority of respondents use a 30-gauge needle for the injection of ranibizumab (78%) and bevacizumab (60%). However, respondents use both a 27- and 30-gauge needle for the injection of triamcinolone acetonide. Conclusions Retinal specialists in the United States participate in a range of techniques for the care before, during, and after intravitreal injections. Further study is needed to elucidate best practice patterns.