Literature DB >> 24862772

Survey of intravitreal injection techniques and treatment protocols among retina specialists in Canada.

Lin Xing1, Stephen J Dorrepaal2, Jeffrey Gale1.   

Abstract

OBJECTIVE: To describe intravitreal injection (IVI) techniques and treatment protocols by retina specialists in Canada from August 1, 2012, to October 1, 2012.
DESIGN: Cross-sectional survey. PARTICIPANTS: All fellowship-trained retina specialists across Canada, as identified from the Canadian Ophthalmological Society directory and the Canadian Retina and Vitreous Society directory.
METHODS: An anonymous 28-question survey was sent to 125 retina specialists across Canada by email. Reminder letters were sent by email, mail, and fax as necessary.
RESULTS: A total of 75 (63%) retina specialists responded to the survey. Most IVIs were performed in the office. Most surgeons did not use gloves (61%), sterile draping (91%), or surgical mask (71%). Antisepsis was used on conjunctiva by 100% and on periocular skin by 48%. Nearly all specialists used a sterile lid speculum (91%). Common anaesthetics included topical proparacaine or lidocaine drops (90%), topical lidocaine gel (25%), topical pledget (23%), and subconjunctival lidocaine injections (23%). Most (83%) dilate the pupil before IVI. Prophylactic topical antibiotics were used by 43%; 50% of these were started immediately after IVI. Injection location was estimated by visualization by 45%. A majority (63%) inject inferotemporally. Anterior chamber paracentesis was performed routinely by 5%. Optic nerve perfusion was formally assessed by 48%. The most common treatment protocol for age-related macular degeneration was treat and extend. For both diabetic and retinal vein occlusion-related macular edema, the most common protocol was 3 initial monthly injections with PRN follow-up.
CONCLUSIONS: A wide variety of IVI practice patterns exist in terms of aseptic technique, anaesthetics, prophylactic antibiotics, postinjection monitoring, and treatment protocol.
Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

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Year:  2014        PMID: 24862772     DOI: 10.1016/j.jcjo.2014.03.009

Source DB:  PubMed          Journal:  Can J Ophthalmol        ISSN: 0008-4182            Impact factor:   1.882


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