Intravitreal silicone oil droplets following pegaptanib injection

Kocabora, Mehmet Selim; Özbilen, Kemal Turgay; Serefoglu, Kubra

doi:10.1111/j.1755-3768.2008.01336.x

Cited by 19 publications

(12 citation statements)

References 6 publications

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“…Görülen bu komplikasyon bizim çalışmamızda olduğu gibi enjekte edilen ajanlara değil kullanılan ekipmanla ilişkilendirilmiştir. [10][11][12][13][14][15] Ness ve ark'nın intravitreal bevacizumab enjeksiyon yapılan 3357 hasta içinden 11 hastada ciddi intraoküler inflamasyon görülmesini içeren çalışmalarında bir hastada retinal abse içeren enfeksiyöz endoftalmi, diğerlerinde toksik vitritis tespit edilmiştir. Endoftalmi şüphesiyle 7 hastaya pars plana vitrektomi yapılmıştır.…”

Section: Discussionunclassified

İntravitreal Enjeksiyon Sonrasında Vitreus İçinde Gözlenen Silikon Yağı Damlacıklı Olgulara Yaklaşımımız

Rasier¹,

Şenel

Artunay

et al. 2012

tjo

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ÖzetAmaç: İntravitreal enjeksiyon tedavisi gören hastaların takiplerinde enjeksiyon sonrası vitreus içi silikon yağı damlacıklarının komplikasyon olarak görülebildiğini ve bu hastalara yaklaşımımızı açıklamak. Ge reç ve Yön tem: T.C. İstanbul Bilim Üniversitesi Göz Kliniği'ne Aralık 2010 -Şubat 2011 tarihleri arasında intravitreal enjeksiyon tedavisi gören 4 hasta gözün önünde uçuşan cisim yakınmasıyla, 2 hasta da enjeksiyon sonrası rutin kontrol muayenesi için başvurdu. Sonuçlar: Yapılan oftalmolojik muayenede fundus bakısında vitreus içinde serbest silikon yağı damlacıkları gözlendi. Bevacizumab enjeksiyonu yapılmış hastalardan %0,04'ünde intravitreal silikon yağı damlacığına rastlanılmışken ranibizumab enjeksiyonu yapılmış hastaların hiçbirinde bu bulguya rastlanılmadı. Vitreus içi silikon yağı damlacığı görülmesinden önce ortalama enjeksiyon sayısı 4,8 (3-8) olup, hastaların almış oldukları toplam enjeksiyon sayısı ortalaması 6,8 (3-9)'dır. Toplam 6 hastanın 2 tanesi asemptomatik, 4 tanesi semptomatikti. Semptomatik olan 2 hastanın vitreuslarında gözlenen silikon yağı damlacıları optik aks üzerinde bulunduğu için pars plana vitrektomi yöntemiyle çıkarıldı. Vitreus ekstraktlarının patolojik incelenmesinde görülen damlacıkların silikon yağı olduğu doğrulandı. Tar t›fl ma: Çalışmamızda intravitreal bevacizumab enjeksiyonlarında kullanılan enjektör ekipmanının vitreus içi silikon yağı damlacığı komplikasyonunu beraberinde getirebildiği saptanmış olup bu durumun ekipman değişimi ile önlenebileceği görülmüştür. Sum maryPur po se: To demonstrate that post-injection intravitreal silicone oil droplets can be seen as a complication in the follow-up of patients who had undergone intravitreal injection treatment and to discuss our clinical approach to these patients. Ma te ri al and Met hod: Out of 6 patients who had undergone intravitreal injection treatment in T. C. Istanbul Bilim University Ophthalmology Clinic between December 2010 and February 2011, four presented with complaints of floaters and 2 patients applied for followup after intravitreal injection. Re sults: On ophthalmological examination, free silicone oil droplets in the vitreous cavity were observed at fundoscopy. In 0.04% of patients who had undergone bevacizumab injections, intravitreal silicone oil droplets were seen, whereas no oil droplets were seen in patients who had undergone ranibizumab injections. Before silicone oil droplets were seen in the vitreous, the mean number of injections was 4.8 (3-8) and the mean number of the total injections that the patients have undergone was 6.8 (3-9). Two of the 6 patients were asymptomatic and 4 of them were symptomatic. The silicone oil droplets in the vitreous which were on the optical axis were extracted with pars plana vitrectomy method in two symptomatic patients. Pathological examination of the vitreous extracts confirmed that the observed droplets were silicone oil. Dis cus si on: In our study, it was determined that the injector equipment which is used in bevacizumab injections can bring along the c...

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Section: Discussionunclassified

İntravitreal Enjeksiyon Sonrasında Vitreus İçinde Gözlenen Silikon Yağı Damlacıklı Olgulara Yaklaşımımız

Rasier¹,

Şenel

Artunay

et al. 2012

tjo

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“…Although often associated with trauma [14-16], surgery [14-17] and chalazions [13-16], there are reports of pyogenic granuloma formation after foreign bodies such as natural or synthetic fibers [16], contact lens [16], scleral buckle [14], and insect wing [14]. We hypothesize that a component of the intravitreal injection procedure such as talc from a disposable glove, cotton fibers from the sterile applicator, or silicone oil derived from the syringe [20-22] could have triggered foreign body reaction at the level of the conjunctiva. Also, repeated injections in the same quadrant of the eye might have increased the risk of this complication.…”

Section: Discussionmentioning

confidence: 99%

Presumed Pyogenic Granuloma Associated with Intravitreal Anti- Vascular Endothelial Growth Factor Therapy

Jung

Torre²,

Fell³

et al. 2011

TOOPHTJ

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“…Silicone oil droplets in fluid from those syringes can be found in a range of sizes from microscopic 5 to large and visually significant in the eye. 3 Although rare case reports of silicone oil droplets were previously reported, [6][7][8][9][10] there was a sharp increase in reported silicone oil droplets in 2016, and it is interesting to note that nearly all recently reported silicone oil adverse events occurred with insulin syringes, even though tuberculin syringes are also commonly used for intravitreal injection. 11 We hypothesized that dead space in syringes that connect to a separate needle via a Luer-Lok or Luer Slip adaptor (eg, tuberculin syringes) contributes to why silicone oil adverse events are less common for such syringe types.…”

Section: Introductionmentioning

confidence: 99%

Silicone Oil Droplets are More Common in Fluid From BD Insulin Syringes as Compared to Other Syringes

Emerson

2017

Journal of VitreoRetinal Diseases

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During 2016 and 2017, numerous retina specialists reported silicone oil droplets after intravitreal injection, primarily associated with insulin syringes with a fixed needle. By contrast, adverse events were relatively rare for tuberculin syringes. We hypothesized that fixed-needle syringe injections have more silicone droplets due to the lack of dead space at the syringe-needle junction. Methods: Fluid from Becton Dickenson (BD) insulin syringes, BD tuberculin syringes, Henke Sass Wolf (HSW) insulin syringes, and HSW silicone-free syringes was examined microscopically for silicone oil droplets. Fluid was sampled at the beginning, middle, and end of injection; and droplets were photographed and quantified. Results: Silicone oil droplets were identified in 30% of the BD insulin syringes, measuring 0.9 + 0.2 mm 3 ; no oil droplets were found in BD tuberculin syringes or HSW silicone-free syringes (analysis of variance, P < .05). All 6 samples with silicone oil droplets were from the end of injection (full depression of the plunger), while samples from the beginning and middle of injections did not have droplets. Challenging syringes with extra silicone oil resulted in increased droplets for fixed-needle syringes (but not for syringes with detachable needles). Conclusion: Significant silicone oil droplets were present in BD insulin syringes and were expressed at the end of injection (with plunger depressed maximally), supporting the hypothesis that insulin syringe injections have more droplets due to the lack of dead space where the plunger meets the hub of the needle. However, there are additional factors such as the amount or type of silicone lubricant in a syringe.

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Intravitreal silicone oil droplets following pegaptanib injection

Cited by 19 publications

References 6 publications

İntravitreal Enjeksiyon Sonrasında Vitreus İçinde Gözlenen Silikon Yağı Damlacıklı Olgulara Yaklaşımımız

İntravitreal Enjeksiyon Sonrasında Vitreus İçinde Gözlenen Silikon Yağı Damlacıklı Olgulara Yaklaşımımız

Presumed Pyogenic Granuloma Associated with Intravitreal Anti- Vascular Endothelial Growth Factor Therapy

Silicone Oil Droplets are More Common in Fluid From BD Insulin Syringes as Compared to Other Syringes

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