Intravitreal Injections of Bevacizumab: The Impact of Needle Size in Intraocular Pressure and Pain

J Curr Glaucoma Pract. 2017 May-Aug;11(2):38-41. doi: 10.5005/jp-journals-10028-1220. Epub 2017 Aug 5.

Abstract

Aim: To compare the effect of 30-gauge vs 27-gauge needle size on intraocular pressure (IOP) rise and patients' pain experience after intravitreal injection (IVI) of bevacizumab.

Materials and methods: Cross-sectional, randomized, double-armed study. Patients were randomized to IVI with 30-gauge or 27-gauge needle. The IOP was measured pre and post IVI. Patients' pain was graded using the visual analog scale (VAS).

Results: A total of 54 eyes were included. The IVI caused a significant IOP rise in both groups (p < 0.001). In the 30-gauge group, the mean pre- and postinjection IOP was 16.3 ± 3.6 mm Hg and 24.1 ± 9.0 mm Hg. The corresponding figures in the 27-gauge group were 18.0 ± 2.54 (p = 0.26) and 23.1 ± 7.5 mm Hg (p = 0.66). In the 30-gauge group, the mean VAS pain score was 3.2 ± 2.6 compared to 3.0 ± 2.5 in the 27-gauge group (p = 0.78).

Conclusion: The IVI caused a significant rise in IOP after the injection, independently of the needle size used. The 27-gauge needle coursed with lower postinjection IOP without prejudice of the patient comfort.

Clinical significance: The IVI with 27-gauge may be considered for glaucomatous eyes (higher risk eyes), for which IOP spikes are not recommended.

How to cite this article: Loureiro M, Matos R, Sepulveda P, Meira D. Intravitreal Injections of Bevacizumab: The Impact of Needle Size in Intraocular Pressure and Pain. J Curr Glaucoma Pract 2017;11(2):38-41.

Keywords: Intraocular pressure; Intravitreal injections; Pain; Visual analog scale.; Bevacizumab.