Krauthammer Mark, Harel Gal, Moisseiev Elad
Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel.
Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel; and.
Retina. 2023 Mar 1;43(3):514-519. doi: 10.1097/IAE.0000000000003693.
To evaluate the effect of syringe design and filling technique on the accuracy of anti-vascular endothelial growth factor delivery.
Volume output was measured with three syringe designs: a 1.0-mL slip-tip syringe, a 1.0-mL Luer-lock syringe, and a ranibizumab prefilled syringe-using two filling techniques ("upward" and "downward") and two fluids (water and bevacizumab). A total of 300 simulated injections were performed. Accuracy was determined by difference from the intended volume of 50 µ L and by mean absolute percentage error.
Volume outputs were significantly different between syringe designs, with mean values of 61.99 ± 4.18 µ L with the 1-mL slip-tip syringe, 57.43 ± 4.95 µ L with the Luer-lock 1-mL syringe, and 51.06 ± 4.74 µ L with the ranibizumab syringe, making the latter the most accurate syringe. There were 37 cases (12.3%) of underdosing below 50 µ L, the majority of which occurred with the ranibizumab syringe. The "downward" technique reduced the occurrence of air bubbles.
Intravitreal injections using 1.0-mL syringes are less accurate than using the ranibizumab prefilled syringe, which has a low-volume and low dead-space plunger design. The variability in volume output may result in less predictable treatment response, especially in cases of underdosing, which were more common with the ranibizumab syringe.
评估注射器设计和填充技术对抗血管内皮生长因子给药准确性的影响。
使用三种注射器设计测量体积输出：1.0毫升滑头注射器、1.0毫升鲁尔锁注射器和雷珠单抗预填充注射器，采用两种填充技术（“向上”和“向下”）以及两种液体（水和贝伐单抗）。共进行了300次模拟注射。通过与预期体积50微升的差值以及平均绝对百分比误差来确定准确性。
不同注射器设计的体积输出存在显著差异，1毫升滑头注射器的平均值为61.99±4.18微升，1毫升鲁尔锁注射器为57.43±4.95微升，雷珠单抗注射器为51.06±4.74微升，这使得雷珠单抗注射器最为准确。有37例（12.3%）给药量低于50微升，其中大多数发生在使用雷珠单抗注射器时。“向下”技术减少了气泡的出现。
使用1.0毫升注射器进行玻璃体内注射的准确性低于使用雷珠单抗预填充注射器，后者具有低容量和低死腔的柱塞设计。体积输出的变异性可能导致治疗反应的可预测性降低，尤其是在给药不足的情况下，这种情况在使用雷珠单抗注射器时更为常见。
