J Retin.  2021 Nov;6(2):75-83. 10.21561/jor.2021.6.2.75.

Release of Silicone Oil Droplets from Off-label Syringes Used for Intravitreal Injection

• Song YY
• Lee JH
• Lee MW
• Lee YH
• Baek SK

• KMID: 2552172
• DOI: http://doi.org/10.21561/jor.2021.6.2.75

Abstract

Purpose
This study aimed to compare the release of silicone oil (SO) by different brands of off-label syringes for intravitreal injection after agitation by flicking.
Methods
Syringes of 3 different brands were analyzed for rates of SO release under four conditions using a light microscope; group 1: bevacizumab with agitation; group 2: bevacizumab without agitation; group 3: fluid with agitation, group 4: fluid without agitation.
Results
The presence of SO droplets showed significant difference according to syringe type (p < 0.001, 65%, 7.5%, 40%, respectively). For qualitative data on the presence of SO droplets according to agitation, Syringe 1 and Syringe 3 showed significantly higher frequency in the agitation group (p < 0.001, p = 0.003). For quantitative data on the number of SO droplets according to agitation, Syringe 1 and Syringe 3 released significantly more SO droplets in the agitation group (p < 0.001, p = 0.001). However, there was no difference in the comparison of frequency and number of SO droplets according to fluid type in all syringes.
Conclusions
Specific syringe use for intravitreal injections has potential to release more SO droplets than other syringes, especially after agitation by flicking. We advise avoidance of agitation during intravitreal injection and recommend manufacturers consider producing syringes specific for ophthalmic use.

Keyword

Agitation; Intravitreal injection; Silicone oil droplets; Syringe