Comparison of Pain Scores, Vitreous Reflux and Intraocular Pressure in Patients Who Received Intravitreal Injection with Different Size Needle.

Abstract

Purpose Intravitreal injection (IVI) is a common vitreoretinal procedure, and most of the patients, over the course of their disease, have to multiple IVI. Pain sensations during IVI may reduce the desire to continue the repeated IVI and cause sudden movements of the eye that to occur complications. The aim of this study to compare the effect of needle size on immediate intraocular pressure (IOP), vitreous reflux and patients’ pain experienced after the IVI. Methods A hundreds and ten eyes of 110 patients who were firstly administered intravitreal ranibizumab or aflibercept were randomized according to the use of needle size, 30-gauge (Group 1) or 26-gauge (Group 2). The reflux was graded post-IVI procedure. Immediately after the IVI, patients were administered to visual analogue scale (VAS) to assess the pain degree. The IOP measurements were taken 30 minutes after the operation. The average of these scores was used as the primary outcome. Results Both groups consisted of 55 patients were included the study. The mean VAS score was 2.18 in group 1 and 4 in the group 2. The reflux grade of the group 1 was also lesser than that of the group 2. IOP was comparable between the groups (26.3 ± 5.66 / 25.4 ± 4.02 mmHg). Groups were divided into subgroups according to the intravitreal agent use, there was not a statistically significant difference in the VAS scores. Conclusions Thirty-gauge needle is more comfortable and safer than 26-gauge needle for the IVI.