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C. Van Went, V. Le Tien, G. Mimoun, N. Leveziel, V. Parier, M. Voigt, F. Coscas, G. Coscas, G. Soubrane, E. Souied; Comparison Between 32 versus 30 Gauge Needles Used for Intra-Vitreal Injection. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5615.
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Intra-vitreal injections of antiangiogenic agents are actually the first therapeutic option for subfoveal choroidal neovascularization in Age-related Macular Degeneration (AMD). Thus the number of intra-vitreal injections (IVT) has recently significantly increased but the technique remains uncomfortable. The purpose of this study is to compare two types of needles (30 Gauge vs 32 Gauge).
This prospective non randomized study included two groups of 100 patients with subfoveal choroidal neovascularisation related to AMD and treated by IVT of ranibizumab in our referal center in November 2007. Study criterias were grading of pain immediately after the injection, resistance during the injection and reflux. Pain grading was evaluated on a scale graduated from 0 (no pain) to 10 (maximal pain), injection resistance from 0 to 5 and reflux from 0 to 5. Questionnaires were collected by the nurse team.
Pain grading remains a subjective evaluation particularly in such a stressful condition in elderly population. No technical problem was related but the resistance during the injection was significantly more important with the 32 G needle.This study does not show a significant difference for pain criteria between the two groups. On the other hand, the reflux is less frequent in 32 G group. This could be useful to decreased systemic diffusion and infectious risk and also for the dosage delivered inside eye.
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