Comparison of pain during intravitreal dexamethasone, ranibizumab and aflibercept injection

Ertan, Elif; Duman, Rahmi

doi:10.1111/cxo.12974

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Intravitreal injection pain reported in previous studies is generally mild. 1–12 In our trial, the mean VAS score of Group 4 was 1.97 ± 1.04, slightly higher than the 1.74 ± 1.71, 9 1.76 ± 0.92, 3 1.78 ± 1.44, 18 and 1.85 ± 1.15 4 reported elsewhere but lower than those reported in other studies (2.8 ± 2.3 and 3.1 ± 2.6, 1 3.05 ± 2.01, 3.17 ± 2.18, and 3.39 ± 2.26, 2 2.05 ± 1.13, 4 2.08 ± 2.03, 11 3.17 ± 2.18, 12 3.38 ± 2.31, 3.82 ± 2.46 and 3.61 ± 2.94, 19 2.81 ± 2.34, 20 3.28 ± 2.45 and 4.20 ± 2.30, 21 3.418 ± 1.483 18 ). The highest pain score was 3.35 ± 2.31 (Group 1), which is also lower than some of the abovementioned trials.…”

Section: Discussionmentioning

confidence: 93%

Effect of Anesthesia Duration on Intravitreal Injection Pain：A Double-blinded Randomized Comparative Study

Liang

Xue

et al. 2023

Retina

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Purpose: To determine the effect of different durations of topical anesthesia on intravitreal injection (IVI) pain. Methods: This was a double-blinded, randomized, comparative study. Three hundred and twelve sequential eyes undergoing IVI were randomized to one of six groups according to the duration of topical anesthesia (from 1 to 30 minutes, one group for every 5-minute range, Groups 1–6). Topical anesthesia before IVI was standardized. Patients graded their pain using the visual analog scale and the Wong–Baker FACES scale at 15 minutes after the procedure. Results: The pain scores among the six groups were significantly different for the visual analog scale (P = 0.013) and Wong–Baker FACES scale (P = 0.024). The mean pain scores for Group 4 were 1.97 ± 1.04 (visual analog scale) and 2.02 ± 1.08 (Wong–Baker FACES scale) and were significantly lower than those of Group 1, 2, 5, or 6. Conclusion: The duration of topical anesthesia significantly correlated with IVI pain. Preoperative 0.5% proparacaine hydrochloride drops were most effective in relieving IVI pain 11 to 20 minutes after topical administration.

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Section: Discussionmentioning

confidence: 93%

Effect of Anesthesia Duration on Intravitreal Injection Pain：A Double-blinded Randomized Comparative Study

Liang

Xue

et al. 2023

Retina

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“…In the literature, 162 patients were compared with visual analogue scale (VAS) and no difference was found between aflibercept ranibizumab and dexamethasone implant in terms of pain (8). Pain was found to be less in cases of advanced age, male gender and pseudophakic (8).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Bilateral Intravitreal Ranibizumab Administration on Pain in Diabetic Retinopathy

COŞKUN

2024

Medical Records

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Aim: To investigate the effect of intravitreal ranibizumab (IVR) bilateral application on pain in diabetic patients Materials and Methods: Forty-two eyes of 42 patients who underwent bilateral IVR for diabetic retinopathy and macular oedema were considered as group 1 and 42 eyes were considered as group 2. Patients who underwent previous intravitreal injection, underwent any eye surgery and were not able to co-operate in the evaluation were excluded from the study. During the injection, pain was assessed using a numerical scale(NS) (Figure 1) and a verbal category scale (VCS) (Figure 2). Results: The mean age of 20 male (47.7%) patients in the groups was 59.90±6.03 years, and the mean age of 22 female (52.3%) patients was 60.72±3.88 years.(p=0.52) In Group 1, the NS was 3.78±1.11, while in Group 2 it was 4.14±1.37, the difference was statistically significant (p=0.01). In group 1, VCS was 2.30±0.71, while in group 2, VCS was 2.73± 0.93, the difference was statistically significant (p=0.01) (Table ) Conclusion: In diabetic patients who underwent bilateral IVR in the same session, pain sensation in the first injected eye was found to be less.

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“…On the other hand, the recurrence of macular edema, requiring repeated injections over time, is still a considerable issue for the management of DMO patients. Pain experienced by patients due to several surgical procedures may influence patients’ compliance and their decision on whether to continue treatment, eventually leading to a decreased quality of life [ 23 ]. Furthermore, the possible development of cataracts necessitating surgery and an intraocular pressure rise may also limit the use of IDI [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant (IDI) Alone and Combined with Navigated 577 nm Subthreshold Micropulse Laser (SML) for Diabetic Macular Oedema

Toto¹,

D’Aloisio²,

Quarta³

et al. 2022

JCM

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Background: The anatomical and functional changes after intravitreal dexamethasone implant (IDI) alone and combined with navigated subthreshold micropulse laser (NSML) in diabetic macular oedema (DMO) were compared. Methods: Patients with a clinically confirmed diagnosis of non-proliferative diabetic retinopathy (NPDR) and DMO were enrolled in this prospective study and were randomly assigned to two different treatment groups: thirty patients were treated with IDI (IDI group), and the other 30 patients received IDI combined with NSML treatment (combined IDI/NSML group). All patients during a 6-month follow-up underwent best corrected visual acuity (BCVA) evaluation and spectral domain optical coherence tomography (SD OCT). The main outcome measures were: BCVA, central macular thickness (CMT); (3) choroidal vascularity index (CVI), subfoveal choroidal thickness (SCHT); and time to retreatment between IDI at baseline and the second implant in both groups. Results: BCVA, CMT, and SCHT significantly decreased starting from the 1-month follow-up and CVI from 3 months in both groups. The between-group differences were significantly different from 1-month follow-up for BCVA, from 5-month follow-up for CMT and SCHT, and from 4-month follow-up for CVI. The Needed to Treat analysis indicated that six patients would have to be treated with SML after IDI in order for just one person to receive a benefit. Conclusions: the combined treatment showed good anatomical and functional outcomes for the treatment of DMO. In addition, IDI/SML seems to reduce injection frequency over time, improving patients’ quality of life and reducing the socio-economic burden.

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Comparison of pain during intravitreal dexamethasone, ranibizumab and aflibercept injection

Cited by 6 publications

References 25 publications

Effect of Anesthesia Duration on Intravitreal Injection Pain：A Double-blinded Randomized Comparative Study

Effect of Anesthesia Duration on Intravitreal Injection Pain：A Double-blinded Randomized Comparative Study

The Effect of Bilateral Intravitreal Ranibizumab Administration on Pain in Diabetic Retinopathy

Intravitreal Dexamethasone Implant (IDI) Alone and Combined with Navigated 577 nm Subthreshold Micropulse Laser (SML) for Diabetic Macular Oedema

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