TY - JOUR
T1 - REDUCTION OF POSTINTRAVITREAL INJECTION PAIN USING ICE
AU - Yahalomi, Tal
AU - Hecht, Idan
AU - Lagstein, Oded
AU - Nemet, Achia
AU - Pe’Er, Liron
AU - Hadad, Fady
AU - Keren-Yaar, Ari
AU - Kassem, Rabea
AU - Burgansky-Eliash, Zvia
AU - Bar, Asaf
AU - Achiron, Asaf
N1 - Publisher Copyright:
Copyright © by Ophthalmic Communications Society, Inc.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Purpose: Intravitreal injections of intraocular therapeutic agents are a common and effective treatment for various retinal pathologies. Patient discomfort related to injection is a potential barrier to treatment. Our aim in this study was to evaluate whether cooling the eye using topical ice compresses before intravitreal injection will reduce pain or bleeding. Methods: This randomized controlled open-label study included 42 patients. All patients received a standard topical anesthesia protocol and then were randomly assigned to either receive a placement of ice packs (intervention group) or a room-temperature pack (control group) on the eyelid, 2 minutes before the intravitreal injection. Patients’ discomfort, itching, burning and pain (using visual analog scale), and bleeding size (using photographs) were measured 1 and 10 minutes after the injection. Tolerability was calculated by averaging patients’ discomfort, itching, burning, and pain scores. Results: At 1 minute, pain (1.95 vs. 4.27, P = 0.01) and overall tolerability (1.66 vs. 2.98, P = 0.03) were significantly lower in patients receiving ice packs. At 10 minutes, pain (1.6 vs. 3.73, P = 0.02), burning (0.9 vs. 3.09, P = 0.007), discomfort (2.1 vs. 4.27, P = 0.008), and overall tolerability (1.23 vs. 2.87, P = 0.004) were all significantly lower in the ice group compared with the controls. Bleeding size (area or circumference) was not statistical different between groups. Conclusion: Topical ice patch administered before intravitreal injection significantly decreased pain and overall tolerability. This simple and inexpensive method may be used to ameliorated pain and improve tolerability.
AB - Purpose: Intravitreal injections of intraocular therapeutic agents are a common and effective treatment for various retinal pathologies. Patient discomfort related to injection is a potential barrier to treatment. Our aim in this study was to evaluate whether cooling the eye using topical ice compresses before intravitreal injection will reduce pain or bleeding. Methods: This randomized controlled open-label study included 42 patients. All patients received a standard topical anesthesia protocol and then were randomly assigned to either receive a placement of ice packs (intervention group) or a room-temperature pack (control group) on the eyelid, 2 minutes before the intravitreal injection. Patients’ discomfort, itching, burning and pain (using visual analog scale), and bleeding size (using photographs) were measured 1 and 10 minutes after the injection. Tolerability was calculated by averaging patients’ discomfort, itching, burning, and pain scores. Results: At 1 minute, pain (1.95 vs. 4.27, P = 0.01) and overall tolerability (1.66 vs. 2.98, P = 0.03) were significantly lower in patients receiving ice packs. At 10 minutes, pain (1.6 vs. 3.73, P = 0.02), burning (0.9 vs. 3.09, P = 0.007), discomfort (2.1 vs. 4.27, P = 0.008), and overall tolerability (1.23 vs. 2.87, P = 0.004) were all significantly lower in the ice group compared with the controls. Bleeding size (area or circumference) was not statistical different between groups. Conclusion: Topical ice patch administered before intravitreal injection significantly decreased pain and overall tolerability. This simple and inexpensive method may be used to ameliorated pain and improve tolerability.
KW - Age-related macular degeneration
KW - Central retinal vein occlusion
KW - Diabetic macular edema
KW - Intravitreous injection
KW - Pain
UR - http://www.scopus.com/inward/record.url?scp=85083503695&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000002608
DO - 10.1097/IAE.0000000000002608
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C2 - 31305506
AN - SCOPUS:85083503695
SN - 0275-004X
VL - 40
SP - 1434
EP - 1438
JO - Retina
JF - Retina
IS - 7
ER -