2M.D., Düzce Atatürk State Hospital, Eye Clinic, Düzce/TURKEY Purpose: Intravitreal injections may cause intraocular pressure (IOP) elevation and subconjunctival reflux. In this study we aimed to investigate the effect of the bore size of the needles used for intravitreal bevacizumab (IVB) injections on acute IOP changes and subconjunctival reflux.
Materials and Methods: Data from 93 consecutive IVB injections were reviewed retrospectively. Eighty seven patients who underwent 2.5 mg/0.1 ml injection of IVB were enrolled in this study. The main outcome measures were the postinjectional IOP, IOP mean elevation rate and reflux grade. All measures were compared according to the bore size of the needles used (27-gauge versus 30-gauge).
Results: A significant elevation in IOP was observed immediately after injection in all eyes. The IOP elevation rate was greater in 30 gauge group when compared with 27-gauge group (Medians: 167% vs 83%, respectively, p=0.001). The reflux grade with 27-gauge needles was greater than that with 30-gauge needles. The medians of the reflux grade were 1 (0-3) (corresponding to a minimal reflux) and 0 (0-3) (corresponding to no reflux), respectively.
Conclusion: A higher IOP elevation is expected if a small-gauge needle is used for IVB injection. Clinicians should be cautious about bore size related IOP spikes, especially in eyes with already compromised perfusion status such as advanced glaucoma and macular ischemia.
Keywords : Intravitreal injection, bevacizumab, intraocular pressure, subconjunctival reflux