Alternative technique for reducing compound waste during intravitreal injections

• Autor(a) principal: Ribeiro,Jefferson Augusto Santana
• Data de Publicação: 2009
• Outros Autores: Messias,André, Scott,Ingrid U., Jorge,Rodrigo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Arquivos brasileiros de oftalmologia (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492009000500008
• topic: Angiogenesis inhibitors; Injections; Retinal diseases; Ophthalmologic surgical procedures; Macular degeneration; Drug administration routes; Vitreous body

PURPOSE: To describe an intravitreal injection technique using a commercially available 29-gauge insulin needle syringe (29GN syringe) and a 21-gauge (G) needle, comparing compound waste associated with this technique application and the one described in ranibizumab (Lucentis®) kit instructions. METHODS: Ten 0.3 ml doses of distilled water were aspirated using the 29GN syringe and 21G needle (PT technique), and another ten equal doses were aspirated employing the sterilized Lucentis® kit (LK technique), which contains a 1ml tuberculin syringe, a 18G needle for compound aspiration and a 30G needle for intravitreal injection. For aspiration using the PT technique, a 21G needle is attached over a 29GN syringe. After compound aspiration, the 21G needle is removed and intravitreal injection is performed using the 29G needle. Using a precision balance, the aspiration needles (21G for PT; 18G for LK) were weighed before and after water aspiration and the syringe-needle complexes for injection (29GN for PT; 30G for LK) were weighed before aspiration and after emptying them. The volumes left in the aspiration needles and needle-syringe complexes were estimated by the difference in weight in grams, which were converted to millilitres. RESULTS: The mean (±SD) residual volume (ml) of aspiration needles (21G for PT; 18G for LK) was significantly lower with PT technique (0.0034 ± 0.0016) when compared to LK tech nique (0.0579 ± 0.0011) (p<0.01). The mean (±SD) residual volume (ml) of syringe-needle complexes was significantly lower with PT technique (0.0056 ± 0.0011) than with LK (0.0906 ± 0.003 ml) (p<0.01). CONCLUSION: The proposed technique is a reasonable alternative for minimizing medication loss during intravitreal injection procedures.