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A. R. Gohari, R. L. Willson, G. M. Cousins, G. Cohen, K. A. Gitter; Patient Comfort With 30-Gauge versus 31-Gauge Intravitreal Injection. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4196.
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To study the effect of needle size (30-gauge versus 31-gauge) on patient self-reported pain scale (0-10).
Prospective study of forty seven patients who received intravitreal injections by two surgeons at two clinic sites. IRB approval was obtained prior to study. Patient participation was completely voluntary. Exclusion criteria included severe dementia, inability to rate pain on a standard 1-10 scale, and baseline ocular pain prior to injection. The decision to perform intravitreal injection was solely based each patient’s underlying diagnosis confirmed by slit lamp biomicroscopy, indirect ophthalmoscopy, optical coherence tomography, and intravenous flourescence angiography. Patients were asked to rate their pain associated with intravitreal injection immediately after the procedure on a standard 0-10 scale with zero indicating no perception of pain. The method of topical anesthesia was identical for all patients. The two intravitreal medications that were administered in this study included triamcinolone acetonide and bevacizumab.
The average age in this study was seventy seven. Sixty two percent of the participants were female and 38% were male. The average patient-reported pain score on a scale of 0-10 was 3.3±3.0 with zero corresponding to no perception of pain. The patients who underwent intravitreal injection of pharmacologic agent with a 30-gauge needle (n = 13) reported an average pain score of 3.8±2.9. Those who received intravitreal injections with a 31-gauge needle (n = 34) reported an average pain score of 3.1±3.0. There was no statistically significant difference between the pain scores when comparing the 30-gauge needle to 31-gauge needle for the administeration of intravitreal medication. None of the patients in this study experienced complications such as retinal detachment or endophthalmitis.
Most patients tolerate intravitreal injections well with a relatively low average pain score of 3.3±3.0 on a scale of 0-10. No statistically signifiant difference was detected when comparing average pain scores between the 30-gauge group and the 31-gauge group.
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