Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel.
Department of Ophthalmology, Meir Medical Center, 59 Tshernichovsky St, 4428164, Kfar Saba, Israel.
Graefes Arch Clin Exp Ophthalmol. 2021 Dec;259(12):3697-3702. doi: 10.1007/s00417-021-05302-0. Epub 2021 Jul 14.
To evaluate the prevalence of residual air bubbles following intravitreal injections of anti-VEGF agents, and to compare two techniques designed to reduce their occurrence.
Patients who received intravitreal injections reported the presence of air bubbles following the procedure, and were followed to determine when they disappeared. Two techniques used to reduce air bubbles prior to injection were compared-tapping the syringe with the needle up ("upwards" technique) or down ("downwards" technique). Rates of residual air bubbles were compared between techniques, and between different drugs.
The study included 344 intravitreal injections, 172 injected with each technique. The overall rate of residual air bubbles was 11.3%, with 94.9% resolution by 48 h. The rate was significantly lower with the "downwards" technique (7.5% vs. 15.1%, p = 0.027). It was also significantly lower with ranibizumab injected using pre-filled syringes than with bevacizumab and aflibercept (0% vs. 12.1% and 14.7%, p < 0.0001). A questionnaire revealed patients reported medium levels of discomfort and a high importance of avoiding air bubbles.
Residual air bubbles are a common occurrence, likely to be experienced by most patients undergoing repeated injections. This phenomenon may be significantly reduced by using the described "downwards" technique, or pre-filled syringes.
评估抗 VEGF 药物玻璃体内注射后残余气泡的发生率，并比较两种旨在减少气泡发生的技术。
接受玻璃体内注射的患者报告了治疗后存在气泡的情况，并进行了随访以确定气泡何时消失。比较了两种在注射前减少气泡的技术——将注射器针头朝上（“朝上”技术）或朝下（“朝下”技术）敲击。比较了两种技术之间以及不同药物之间残余气泡的发生率。
本研究纳入了 344 例玻璃体内注射，其中 172 例分别采用两种技术进行注射。残余气泡的总体发生率为 11.3%，48 小时内 94.9%的气泡消失。“朝下”技术的发生率显著降低（7.5% vs. 15.1%，p = 0.027）。与贝伐单抗和阿柏西普相比，使用预装注射器注射雷珠单抗的发生率也显著降低（0% vs. 12.1%和 14.7%，p < 0.0001）。问卷调查显示，患者报告了中等程度的不适，且避免气泡的重要性很高。
残余气泡是一种常见现象，可能会被大多数接受重复注射的患者所经历。通过使用描述的“朝下”技术或预装注射器可以显著减少这种现象。
