Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
Graefes Arch Clin Exp Ophthalmol. 2010 Nov;248(11):1573-7. doi: 10.1007/s00417-010-1490-y. Epub 2010 Aug 21.
Intravitreal injections may lead to a significant elevation of the intraocular pressure (IOP). A paracentesis may become necessary for acute reduction of the IOP in certain cases. The purpose of this study was to determine the frequency of paracentesis performed and the grade of reflux under the conjunctiva after injection of 0.1 ml bevacizumab (1.25 mg), depending on the thickness of the needles used.
A retrospective review was undertaken of the surgery reports of 234 consecutive intravitreal bevacizumab injections in 145 eyes of 144 patients within 14 months. In particular, the frequency of paracentesis, the thickness of the needles used (27-gauge versus 30-gauge), the lens status, and a semi-quantitative reflux grade were analysed.
A paracentesis was performed in 78 cases (33%) for acute reduction of the IOP. In the 27-gauge group the frequency was 26% (25 of 96), and in the 30-gauge group 38% (53 of 138) (p = 0.05, independent estimating equation (IEE)). The medians of the semi-quantitative assessment of the reflux grade under the conjunctiva were 2.0 in the 27-gauge group (corresponding to a mild reflux) and 1.0 in the 30-gauge group (corresponding to a minimal reflux, p < 0.001, IEE).
When using a 30-gauge needle for intravitreal injections, the reflux under the conjunctiva was less than with a 27-gauge needle. However, the use of a 30-gauge needle appeared to be associated with a higher frequency of paracentesis.
玻璃体内注射可能导致眼内压（IOP）显著升高。在某些情况下，可能需要进行房水穿刺术以迅速降低IOP。本研究旨在确定根据所用针头的厚度，在注射 0.1ml 贝伐单抗（1.25mg）后行房水穿刺术的频率以及结膜下反流的程度。
回顾性分析了 144 例患者的 145 只眼在 14 个月内连续 234 次玻璃体内注射贝伐单抗的手术报告。特别分析了房水穿刺术的频率、所用针头的厚度（27 号与 30 号）、晶状体状态和半定量反流程度。
为了降低 IOP，有 78 例（33%）患者行房水穿刺术。在 27 号组中，房水穿刺术的频率为 26%（96 例中的 25 例），在 30 号组中为 38%（138 例中的 53 例）（p=0.05，独立估计方程（IEE））。27 号组结膜下反流的半定量评估中位数为 2.0（轻度反流），30 号组为 1.0（轻微反流，p<0.001，IEE）。
在进行玻璃体内注射时，使用 30 号针头比使用 27 号针头时结膜下反流更少。然而，使用 30 号针头似乎与房水穿刺术的频率增加有关。
