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Ghassan Ghorayeb, Rasha Ali, Bernard F. Godley, Gibran S. Khurshid, Fredericus J. Van Kuijk; Assessment Of 32 Gauge Needles For Intravitreal Injections. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1693.
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To evaluate the subjective and objective outcomes of intravitreal Bevacizumab injection with 32 gauge needles as compared to 30 gauge needles in the clinical retina practice.
In this retrospective case series, a total of 60 patients requiring intravitreal Bevacizumab were injected with either 32 gauge needles or 30 gauge needles, with 30 patients in each group. Subjective perception of pain was recorded on a scale of 0-10 for each patient, and objective outcomes of other complications such as subconjunctival hemorrhage were recorded as well. Additionally, needle tips were examined with a microscope pre and post injection for evidence of manufacturing defects, such as bends of the needle tip.
Of the patients who were injected with 32 gauge needles, 50% reported feeling none to minimal discomfort (a score of zero to two), 45% reported feeling moderate pain (a score of 3- or 6) and 5 % reported severe pain (score of 7-10 on the pain scale). Of the patients who were injected with 30 gauge needles, 20% reported feeling none to minimal discomfort (a score of zero-two), 50% reported feeling moderate discomfort (a score of 3-6 on the pain scale), and30% reported feeling severe discomfort (a score of 7-10). The patients who were injected with 32 gauge needles had a higher rate of subconjunctival hemorrhage at 30% as compared to those injected with 30 gauge needles, 15%. 30 gauge needle tips retained their structural integrity the vast majority of the time when examined under the microscope post injection, while several of 32 gauge needle tips were found to have a slight deformity after injection.
Injection with 32 gauge needles results in improved patient comfort as compared to injection with 30 gauge needles, but results in a slightly higher complication rate of subconjunctival hemorrhage. It is recommended to examine the 32 gauge needles under a microscope prior to use.
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