Investigative Ophthalmology & Visual Science Cover Image for Volume 65, Issue 7
June 2024
Volume 65, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2024
Intravitreal injection delivered volume under different environmental and training conditions
Author Affiliations & Notes
  • Gustavo Barreto Melo
    Ophthalmology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
    Hospital de Olhos de Sergipe, Aracaju, Sergipe, Brazil
  • Lucas Andrade Santos
    Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
  • Alexandre Lima Cardoso
    Hospital de Olhos de Sergipe, Aracaju, Sergipe, Brazil
  • Mateus Lins Santos
    Hospital de Olhos de Sergipe, Aracaju, Sergipe, Brazil
  • Lydianne Lumack Monte Agra
    Ophthalmology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
    Hospital de Olhos de Sergipe, Aracaju, Sergipe, Brazil
  • Footnotes
    Commercial Relationships   Gustavo Melo SJJ Solutions, Code C (Consultant/Contractor), Roche, Code F (Financial Support); Lucas Santos None; Alexandre Cardoso None; Mateus Santos None; Lydianne Agra None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2024, Vol.65, 262. doi:
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      Gustavo Barreto Melo, Lucas Andrade Santos, Alexandre Lima Cardoso, Mateus Lins Santos, Lydianne Lumack Monte Agra; Intravitreal injection delivered volume under different environmental and training conditions. Invest. Ophthalmol. Vis. Sci. 2024;65(7):262.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Recognizing that prior knowledge of syringe characteristics, fluid withdrawal techniques, and color backgrounds may impact the effective volume delivered during IVI, we aimed to evaluate the specific roles of environmental and training conditions.

Methods : Three syringe models (BD Plastipak 1mL, Eylea PFS, and Zero Residual Silicone Oil-free 0.2 mL) were tested with 2 different needle setups (30-g BD PrecisionGlide needle attached to BD Plastipak and Eylea PFS syringes, and 30-g Zero Residual needle attached to its corresponding syringe), with distilled water and a target volume of 50 µL. Two subset of experiments were carried out: different colored backgrounds (beige, black, blue, green, and white) by a single operator, and another at a standard white background, by 3 different operators, under 3 circumstances (no prior training, after proper training, and after specific guidance for overpressure). Ten samples were included in each subgroup. The liquid was expelled into an Eppendorf tube, which was weighed with a 0.1 mg precision scale before and after liquid injection. One-way ANOVA and linear regression were used for statistical analysis.

Results : A total of 450 syringe samples were tested. At different colored backgrounds (n=150), BD Plastipak led to an injection volume ranging from 50.9 ± 4.2 µL in white to 54.6 ± 2.0 µL in green (p=0.037); Eylea PFS varied from 58.8 ± 4.2 µL in blue to 64.9 ± 3.9 µL in beige (p=0.004); and Zero Residual Silicone Oil-free ranged from 48.5 ± 2.8 in black µL to 50.4 ± 1.7 µL in green (p=0.361). The second subset of experiments (n=300) showed an influence of the syringe and of the operator, but not of the circumstance, on the volume delivered by the syringe with the linear regression model. One-way ANOVA showed a statistically significant difference in the delivered volume across all groups of syringes (p=0.000) and under the different training circumstances (p=0.024), with a trend for the different operators (p=0.061).

Conclusions : Our study revealed significant variations in IVI volumes, influenced notably by syringe type, operator proficiency, and colored backgrounds. These findings emphasize the need to consider materials and techniques for precision in IVI.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Figure 1- Delivered volume according to different colors of background

Figure 1- Delivered volume according to different colors of background

 

Figure 2- Delivered volume of 3 different syringes, under 3 different training curcumstances, performed by 3 operators

Figure 2- Delivered volume of 3 different syringes, under 3 different training curcumstances, performed by 3 operators

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