SYRINGE DESIGN AND FILLING TECHNIQUE AFFECT ACCURACY OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR INTRAVITREAL INJECTIONS

Mark Krauthammer, Gal Harel, Elad Moisseiev*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose:To evaluate the effect of syringe design and filling technique on the accuracy of anti-vascular endothelial growth factor delivery.Methods:Volume output was measured with three syringe designs: a 1.0-mL slip-tip syringe, a 1.0-mL Luer-lock syringe, and a ranibizumab prefilled syringe - using two filling techniques ("upward"and "downward") and two fluids (water and bevacizumab). A total of 300 simulated injections were performed. Accuracy was determined by difference from the intended volume of 50 μL and by mean absolute percentage error.Results:Volume outputs were significantly different between syringe designs, with mean values of 61.99 ± 4.18 μL with the 1-mL slip-tip syringe, 57.43 ± 4.95 μL with the Luer-lock 1-mL syringe, and 51.06 ± 4.74 μL with the ranibizumab syringe, making the latter the most accurate syringe. There were 37 cases (12.3%) of underdosing below 50 μL, the majority of which occurred with the ranibizumab syringe. The "downward"technique reduced the occurrence of air bubbles.Conclusion:Intravitreal injections using 1.0-mL syringes are less accurate than using the ranibizumab prefilled syringe, which has a low-volume and low dead-space plunger design. The variability in volume output may result in less predictable treatment response, especially in cases of underdosing, which were more common with the ranibizumab syringe.

Original languageEnglish
Pages (from-to)514-519
Number of pages6
JournalRetina
Volume43
Issue number3
DOIs
StatePublished - 1 Mar 2023

Keywords

  • anti-vascular endothelial growth factor
  • filling technique
  • intravitreal injection
  • prefilled
  • syringe
  • volume output

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