1. Survey of intravitreal injection techniques and treatment protocols among retina specialists in Canada.
- Author
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Xing L, Dorrepaal SJ, and Gale J
- Subjects
- Administration, Topical, Anesthesia, Local statistics & numerical data, Anti-Bacterial Agents administration & dosage, Canada, Clinical Protocols, Cross-Sectional Studies, Female, Health Surveys, Humans, Intravitreal Injections statistics & numerical data, Macular Degeneration drug therapy, Macular Edema drug therapy, Male, Middle Aged, Retina, Retinal Vein Occlusion drug therapy, Surveys and Questionnaires, Intravitreal Injections methods, Ophthalmic Solutions administration & dosage, Ophthalmology, Practice Patterns, Physicians', Retinal Diseases drug therapy, Specialization
- 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.)
- Published
- 2014
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