Retina Specialists, Baltimore, Maryland.
Ophthalmol Retina. 2021 Mar;5(3):234-240. doi: 10.1016/j.oret.2020.07.021. Epub 2020 Jul 28.
To compare the prevalence of intravitreal silicone oil microdroplets detected by slit-lamp biomicroscopy in eyes with 6 or more injections of the same anti-vascular endothelial growth factor (VEGF) drug.
Prospective, cross-sectional case series.
A total of 260 consecutive eyes receiving 1 of 3 intravitreal anti-VEGF drugs for choroidal neovascularization, diabetic macular edema, or venous occlusive disease. The control group included 147 fellow eyes with no prior intravitreal injections.
The anterior and mid-vitreous were carefully examined using 12× to 16× magnification through dilated pupils with ocular saccades before an injection. Silicone oil microdroplets were graded on a scale from 0 to 4+ based on the number and size of droplets.
Presence and severity of silicone oil microdroplets in the vitreous.
Silicone oil microdroplets were observed in 78.3% of eyes receiving bevacizumab in Becton Dickinson (BD, Franklin Lakes, NJ) 0.3-mL polypropylene syringes, 14.4% of eyes receiving ranibizumab in 1.0-mL BD polypropylene syringes or more recently glass prefilled syringes, 48.5% of eyes receiving aflibercept in 1.0-mL BD polycarbonate syringes, and 0% of eyes in controls. The differences among the 4 groups were statistically significant at P < 0.001. The severity of silicone oil microdroplets was significantly greater in eyes using BD 0.3-mL polypropylene syringes than BD 1.0-mL polypropylene syringes, BD 1.0-mL polycarbonate syringes, or controls (P < 0.001). The severity of silicone oil microdroplets in eyes using BD 1.0-mL polycarbonate syringes was significantly greater than BD 1.0-mL polypropylene syringes (P = 0.012) and controls (P < 0.001). There was no significant difference between silicone oil microdroplet severity between BD 1.0-mL polypropylene syringes and controls (P = 1.0).
The BD 0.3-mL polypropylene syringes with repackaged bevacizumab and the BD 1.0-mL polycarbonate syringes with aflibercept cause a higher likelihood of silicone oil microdroplets. Intravitreal injections in eyes receiving multiple regular anti-VEGF injections should be supplied in silicone-free syringes.
比较 6 次或以上相同抗血管内皮生长因子（VEGF）药物玻璃体腔内注射后，裂隙灯生物显微镜下硅油微滴的发生率。
前瞻性、横断面病例系列。
共有 260 只连续眼接受了 1 种玻璃体腔内抗 VEGF 药物治疗脉络膜新生血管、糖尿病性黄斑水肿或静脉阻塞性疾病。对照组包括 147 只无先前玻璃体腔内注射的对侧眼。
在瞳孔扩张和眼球扫视下，用 12×至 16×放大倍数仔细检查前房和中玻璃体。硅油微滴根据数量和大小按 0 至 4+分级。
玻璃体中硅油微滴的存在和严重程度。
贝朗（Becton Dickinson，新泽西州富兰克林湖）0.3 毫升聚丙烯注射器中贝伐单抗治疗的眼 78.3%观察到硅油微滴，1.0 毫升贝朗聚丙烯注射器或最近的玻璃预装注射器中雷珠单抗治疗的眼 14.4%，1.0 毫升贝朗聚碳酸酯注射器中阿柏西普治疗的眼 48.5%，对照组眼无硅油微滴。4 组间差异有统计学意义（P < 0.001）。使用贝朗 0.3 毫升聚丙烯注射器的眼硅油微滴的严重程度明显大于使用贝朗 1.0 毫升聚丙烯注射器、贝朗 1.0 毫升聚碳酸酯注射器或对照组（P < 0.001）。使用贝朗 1.0 毫升聚碳酸酯注射器的眼硅油微滴的严重程度明显大于使用贝朗 1.0 毫升聚丙烯注射器（P = 0.012）和对照组（P < 0.001）。贝朗 1.0 毫升聚丙烯注射器与对照组硅油微滴严重程度差异无统计学意义（P = 1.0）。
贝朗 0.3 毫升聚丙烯注射器包装的贝伐单抗和贝朗 1.0 毫升聚碳酸酯注射器包装的阿柏西普更容易引起硅油微滴。多次常规抗 VEGF 注射的眼应在无硅注射器中进行玻璃体腔内注射。
