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David Lazar, Adriana Dornelles, Marie D Acierno; Intravitreal Injections: An Observational Review of Technique. Invest. Ophthalmol. Vis. Sci. 2014;55(13):584.
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To evaluate how intravitreal injections are conducted by private ophthalmologists and academic ophthalmologists. This study also delineates the demographic of ophthalmologists conducting intravitreal injections.
The Institutional Review Board of Louisiana State University in New Orleans approved this observational study. The survey was distributed via email to the New Orleans Academy of Ophthalmology and to the list serve of program directors across the country. In addition to several demographic metrics, the primary endpoints for this survey were the measurement of intraocular pressure (IOP) before and after intravitreal injection, use of povidone-iodine prior to injection, use of post-treatment antibiotics and the use of a surgical mask during the procedure.Surveymonkey.com was used as a platform. Chi-squared testing was used to analyze the data collected.
A total of 278 responses were obtained. 71 private ophthalmologists responded. The remaining 207 responses were from active residents or academic ophthalmologists. Among those who perform intravitreal injections (n = 208), there were a statistically higher proportion of doctors who were in academic settings, when compared to non-academic settings (86.3% vs. 42.5%, p-value < 0.001) This study found that a higher proportion of current residents perform intravitreal injections when compared to doctors with 1-10 years of experience (92.1% vs. 78.1%. P-value<0.001). As expected, among those who perform intravitreal injections, retina specialists have a higher proportion when compared to other specialties (P-value <0.001). Current residents constitute the lowest proportion of doctors that check intraocular pressure before and after injection (p-value = 0.009). We also found that doctors at non-academic centers check pressure before and after injection more often than doctors in an academic setting (59% vs 35.5%, p-value 0.006). There is not a significant difference between the various demographic groups regarding the use of pre-injection betadine, use of surgical mask, or post-injection use of antibiotics.
While complications of intravitreal injections are uncommon, the consequences to patients for whom complications occur may be severe. We postulate that while there are recommendations for intravitreal injections, the lack of uniform application may lead to some of these rare complications.
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