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Cited by 114Retinal Diseases and TreatmentsRetinal and Macular SurgeryOcular Infections and Treatments

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Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections

Melo, Gustavo Barreto, Cruz, Natasha Ferreira Santos da, Emerson, Geoffrey Guy, Rezende, Flávio Atanázio, Meyer, Carsten H., Uchiyama, Susumu, Carpenter, John, Shiroma, Hélio Francisco, Farah, Michel Eid, Maia, Maurício, Rodrigues, Eduardo Büchele·2021·Progress in Retinal and Eye Research
DOI 10.1016/j.preteyeres.2020.100862
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Abstract

Intravitreal injections have become the most commonly performed intraocular treatments worldwide. Because intravitreal injections may induce severe adverse events, such as infectious and noninfectious endophthalmitis, cataract, ocular hypertension, vitreous hemorrhage, or retinal detachment, appropriate awareness of the materials and techniques used are essential to reduce these sight-threatening complications. This review provides insights into the needles, syringes, silicone oil coating, sterilization methods, devices to assist intravitreal injections, scleral piercing techniques using needles, syringe handling, anesthesia, and safety issues related to materials and techniques. It is paramount that physicians be aware of every step involved in intravitreal injections and consider the roles and implications of all materials and techniques used. The ability to understand the theoretical and practical circumstances may definitely lead to state-of-the-art treatments delivered to patients. The most important practical recommendations are: choosing syringes with as little silicone oil as possible, or, preferably, none; avoiding agitation of syringes; awareness that most biologics (e.g., antiangiogenic proteins) are susceptible to changes in molecular properties under some conditions, such as agitation and temperature variation; understanding that improper materials and techniques may lead to complications after intravitreal injections, e.g., inflammation; and recognizing that som…

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Metadata

Authors
Melo, G. B., Cruz, N. F. S. D., Emerson, G. G., Rezende, F. A., Meyer, C. H., Uchiyama, S., Carpenter, J., Shiroma, H. F., Farah, M. E., Maia, M., & Rodrigues, E. B.
Affiliations
  • Universidade Federal de São Paulo (BR)
  • The Retina Center (US)
  • Hôpital Maisonneuve-Rosemont (CA)
  • Philipps University of Marburg (DE)
  • The University of Osaka (JP)
  • University of Colorado Denver (US)
  • Saint Louis University Hospital (US)
Corresponding author
Melo, Gustavo Barreto
ORCID
Venue
Progress in Retinal and Eye Research
Publisher
Elsevier BV
Published
2021-01
Volume
80
Pages
100862
ISSN
1350-9462 (ISSN-L)
DOI
10.1016/j.preteyeres.2020.100862
OpenAlex
W3016654382
Cited by
114
References
175
Citations by year
2026: 18 · 2025: 27 · 2024: 15 · 2023: 18 · 2022: 14 · 2021: 18
FWCI
2.29
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Progress in Retinal and Eye Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Japan Agency for Medical Research and Development
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico
  • Pan-American Association of Ophthalmology
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Ophthalmology › Retinal and Macular Surgery
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords
intravitreal injection, syringes, needles, silicone oil coating, sterilization, endophthalmitis, ocular hypertension, vitreous hemorrhage, retinal detachment, injection complications, injection safety
MeSH terms
Animals, Disposable Equipment, Humans, Needles, Silicone Oils, Syringes, Intravitreal Injections

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