Abstract
Objective: To determine the effect of intravitreal injection into different
quadrants on pain score and injection comfort.
Method: 304
patients were divided into 8 groups that included 38 patients in each. The
right and left eyes of the patients were divided into 4 quadrants, superior
temporal, inferior temporal, superior nasal, and inferior nasal. Intravitreal
injections were performed in the room only used for this purpose and by an
experienced ophthalmologist. To eliminate drug-related factors only
intravitreal ranibizumab applied patients were included in the study. Injections
were performed on one of these quadrants 3.5 mm away from the limbus using 30
gauge needle. All injections were performed under topical proparacaine HCl
anesthesia. The severity of the patient's pain after the injection was evaluated
by using the visual analog scale. Additionally the patient's stinging,
injection comfort and injection safety were also assessed.
Results: 176
(57.9%) of the participants were male and 128 (42.1%) were female. The mean age
of all participants was 61,84±12,49 (20-90). Age (p=0,793), gender (p=0,534),
pain score (p=0,165), stinging score (p=0,264), patient comfort score (p=0,555),
injection safety score (p=0,079) were similar between the groups. Pain
(p<0,001) and stinging (p<0,001) scores were higher in females
(p<0,001). Patient comfort (p=0,001) and injection safety (p=0,019) scores
were lower in females.
Conclusions: No difference was found
between the quadrants in terms of pain score. Therefore, the physicians may prefer the most comfortable quadrant for themselves
and for their patients in intravitreal injection.
References
- 1-Grzybowski A, Told R, Sacu S, Bandello F, Moisseiev E, Loewenstein A, Schmidt-Erfurth U; Euretina Board. 2018 Update on Intravitreal Injections: Euretina Expert Consensus Recommendations. Ophthalmologica. 2018;239(4):181-93.2-Segal O, Segal-Trivitz Y, Nemet AY, Cohen P, Geffen N, Mimouni M. Anxiety levels and perceived pain intensity during intravitreal injections. Acta Ophthalmol. 2016;94 (2):203-4. 3-Davis MJ, Pollack JS, Shott S. Comparison of topical anesthetics for intravitreal injections: a randomized clinical trial. Retina. 2012;32(4):701–5.4-Blaha GR, Tilton EP, Barouch FC, Marx JL. Randomized trial of anesthetic methods for intravitreal injections. Retina. 2011;31(5):535-9.5-Andrade GC, Carvalho AC. Comparison of three different anesthetic approaches for intravitreal injections: a prospective randomized trial. Arq Bras Oftalmol. 2015;78(1):27-31.6-Shin SH, Park SP, Kim YK. Factors associated with pain following intravitreal injections. Korean J Ophthalmol. 2018;32(3):196-203. 7-Rifkin L, Schaal S. Factors affecting patients’ pain intensity during in office intravitreal injection procedure. Retina. 2012;32(4):696-700. 8-Massamba N, Elluard M, Agoune W, Guyader V, Ingram A, Pasquier B, Knoeri J. Assessment of ocular pain following ranibizumabintravitreal injection. Acta Ophthalmol. 2015;93(3):e231-2. 9-Güler M, Bilgin B, Çapkın M, Şimşek A, Bilak Ş. Assessment of patient pain experience during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection. Korean J Ophthalmol. 2015;29(3):190-4.10-Haas P, Falkner-Radler C, Wimpissinger B, Malina M, Binder S. Needle size in intravitreal injections-pain evaluation of a randomized clinical trial. Acta Ophthalmol. 2016;94(2):198-202.11-Shiroma HF, Takaschima AKK, Farah ME, Höfling-Lima AL, de Luca Canto G, Benedetti RH, Rodrigues EB. Patient pain during intravitreal injections under topical anesthesia: a systematic review. Int J Retina Vitreous. 2017;3:23. 12-Karimi S, Mosavi SA, Jadidi K, Nikkhah H, Kheiri B. Which quadrant is less painful for intravitreal injection? A prospective study. Eye (Lond). Eye (Lond). 2019;33(2):304-312.
Abstract
References
- 1-Grzybowski A, Told R, Sacu S, Bandello F, Moisseiev E, Loewenstein A, Schmidt-Erfurth U; Euretina Board. 2018 Update on Intravitreal Injections: Euretina Expert Consensus Recommendations. Ophthalmologica. 2018;239(4):181-93.2-Segal O, Segal-Trivitz Y, Nemet AY, Cohen P, Geffen N, Mimouni M. Anxiety levels and perceived pain intensity during intravitreal injections. Acta Ophthalmol. 2016;94 (2):203-4. 3-Davis MJ, Pollack JS, Shott S. Comparison of topical anesthetics for intravitreal injections: a randomized clinical trial. Retina. 2012;32(4):701–5.4-Blaha GR, Tilton EP, Barouch FC, Marx JL. Randomized trial of anesthetic methods for intravitreal injections. Retina. 2011;31(5):535-9.5-Andrade GC, Carvalho AC. Comparison of three different anesthetic approaches for intravitreal injections: a prospective randomized trial. Arq Bras Oftalmol. 2015;78(1):27-31.6-Shin SH, Park SP, Kim YK. Factors associated with pain following intravitreal injections. Korean J Ophthalmol. 2018;32(3):196-203. 7-Rifkin L, Schaal S. Factors affecting patients’ pain intensity during in office intravitreal injection procedure. Retina. 2012;32(4):696-700. 8-Massamba N, Elluard M, Agoune W, Guyader V, Ingram A, Pasquier B, Knoeri J. Assessment of ocular pain following ranibizumabintravitreal injection. Acta Ophthalmol. 2015;93(3):e231-2. 9-Güler M, Bilgin B, Çapkın M, Şimşek A, Bilak Ş. Assessment of patient pain experience during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection. Korean J Ophthalmol. 2015;29(3):190-4.10-Haas P, Falkner-Radler C, Wimpissinger B, Malina M, Binder S. Needle size in intravitreal injections-pain evaluation of a randomized clinical trial. Acta Ophthalmol. 2016;94(2):198-202.11-Shiroma HF, Takaschima AKK, Farah ME, Höfling-Lima AL, de Luca Canto G, Benedetti RH, Rodrigues EB. Patient pain during intravitreal injections under topical anesthesia: a systematic review. Int J Retina Vitreous. 2017;3:23. 12-Karimi S, Mosavi SA, Jadidi K, Nikkhah H, Kheiri B. Which quadrant is less painful for intravitreal injection? A prospective study. Eye (Lond). Eye (Lond). 2019;33(2):304-312.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Surgical Science Research Articles |
| Authors | |
| Publication Date | September 30, 2019 |
| Acceptance Date | September 28, 2019 |
| Published in Issue | Year 2019Volume: 41 Issue: 3 |