Alshahrani Saeed T, Rubin Uriel, Gupta Vasudha, Gonder Tom, Sharma Sanjay
Ophthalmology Department, King Fahad Medical City, Riyadh, SAU.
Ophthalmology, Queens University, Kingston, CAN.
Cureus. 2021 Apr 6;13(4):e14320. doi: 10.7759/cureus.14320.
To compare reflux, intraocular pressure (IOP) variation and pain following intravitreal (IV) injections using 30-gauge and 32-gauge needles in patients with retinal pathologies in Saudi Arabia.
A double-blind randomized clinical trial was conducted in 2018. Participants were randomized to receive IV injections of Ranibizumab using 30-gauge (Gr) or 32-gauge (Gr) needles. The amount of reflux of injected material, IOP before (IOP) and five minutes after injection (IOP) were measured. The patient-perceived pain score was assessed using a visual analogue score (VAS). Outcome variables were compared.
The study sample was comprised of 86 eyes (86 patients) in each group. Gender (P=0.76), laterality (P=0.55) and age (P=1.0) were not different between groups. The reflux in Gr [34.9% (95% confidence interval {CI}, 24.8; 45.0)] was significantly higher compared to Gr [22.1% (95% CI, 13.3; 30.9)] (P=0.007). The median pain score was 1 in both Gr [interquartile range (IQR) 1.0: 3.0] and Gr (IQR 0.0; 2.0) (P=0.04). Among 56 eyes without reflux in Gr, the IOP and IOP were 13.6±2.7 mmHg and 16.4±5.0 mmHg, respectively. Among 67 eyes without reflux in Gr, the IOP and IOP2 were 13.6±2.9 mmHg and 17.0±5.2 mmHg, respectively. The change in percentage in IOP in Gr and Gr was not significantly different (Mann Whiney P=0.3).
IV injection given by 30-gauge needle compared to 32-gauge needle resulted in greater patient-perceived pain and more reflux of injected material from the injection site. An increase in IOP was not associated with the gauge of the needle used for IV injection.
比较在沙特阿拉伯患有视网膜病变的患者中，使用30号和32号针头进行玻璃体内（IV）注射后的反流、眼压（IOP）变化及疼痛情况。
2018年进行了一项双盲随机临床试验。参与者被随机分配接受使用30号（Gr）或32号（Gr）针头进行的雷珠单抗玻璃体内注射。测量注射材料的反流情况、注射前（IOP）和注射后五分钟（IOP）的眼压。使用视觉模拟评分（VAS）评估患者感知的疼痛评分。比较结果变量。
每组研究样本包括86只眼（86名患者）。两组之间的性别（P = 0.76）、眼别（P = 0.55）和年龄（P = 1.0）无差异。30号组的反流率[34.9%（95%置信区间{CI}，24.8；45.0）]显著高于32号组[22.1%（95%CI，13.3；30.9）]（P = 0.007）。30号组和32号组的中位疼痛评分均为1分（30号组四分位间距（IQR）1.0：3.0；32号组IQR 0.0；2.0）（P = 0.04）。在30号组56只无反流的眼中，注射前眼压和注射后眼压分别为13.6±2.7 mmHg和16.4±5.0 mmHg。在32号组67只无反流的眼中，注射前眼压和注射后眼压分别为13.6±2.9 mmHg和17.0±5.2 mmHg。30号组和32号组眼压的百分比变化无显著差异（Mann - Whiney P = 0.3）。
与32号针头相比，使用30号针头进行玻璃体内注射会使患者感知的疼痛更剧烈，且注射部位的注射材料反流更多。眼压升高与用于玻璃体内注射的针头规格无关。
