Effect of the Honan intraocular pressure reducer on intraocular pressure increase following intravitreal injection using the tunneled scleral technique

Kim, Kyu-seop; Jee, Donghyun

doi:10.1007/s10384-011-0088-1

Cited by 18 publications

(23 citation statements)

References 31 publications

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“…These findings resonate with the results of Kim and Jee who demonstrated that the Honan intraocular pressure reducer, applied to the eye at 30 mmHg for 10 minutes, significantly lowered pre-injection IOP and IOP immediately after intravitreal injection using tunneled scleral technique. 12 The IOP at 10 minutes post-injection was lower in the Honan group as well. The Honan balloon is a bulky and awkward device, which takes significantly greater time than the current method, and carries a risk of producing extremely high IOPs in eyes with higher initial pressure, such as in patients with glaucoma.…”

Section: Discussionmentioning

confidence: 83%

“…The Honan balloon is a bulky and awkward device, which takes significantly greater time than the current method, and carries a risk of producing extremely high IOPs in eyes with higher initial pressure, such as in patients with glaucoma. 12 Therefore, other ways of decompressing the eye, such as gentle pressure with cotton swabs saturated with an anesthetic, should be considered.…”

Section: Discussionmentioning

confidence: 99%

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Ocular Decompression With Cotton Swabs Lowers Intraocular Pressure Elevation After Intravitreal Injection

Gregori

Weiss

Goldhardt

et al. 2014

Journal of Glaucoma

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Objective To determine the effect of pre-injection ocular decompression by cotton swabs on the immediate rise in intraocular pressure (IOP) after intravitreal injections. Methods Forty-eight patients receiving 0.05-ml ranibizumab injections in a retina clinic were randomized to two anesthetic methods in each eye on the same day (if bilateral disease) or on consecutive visits (if unilateral disease). One method utilized cotton swabs soaked in 4% lidocaine applied to the globe with moderate pressure and the other 3.5% lidocaine gel applied without pressure. IOPs were recorded at baseline (before injection) and at 0, 5, 10, and 15 minutes after the injection until the IOP was ≤30 mmHg. The IOP elevations from baseline were compared after the two anesthetic methods. Results The pre-injection mean IOP (SD, mmHg) was 15.5 (3.3) before the cotton swabs and 15.9 (3.0) before the gel (p=0.28). Mean IOP (SD, mmHg) change immediately after injection was 25.7 (9.2) after the cotton swabs and 30.9 (9.9) after the gel (P=0.001). Thirty-five percent of gel eyes had IOP ≥50 mmHg compared to only 10% of cotton swab eyes immediately after the injection (P<0.001). Conclusion Decompressing the eye with cotton swabs during anesthetic preparation prior to an intravitreal injection produces a significantly lower IOP spike after the injection.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Ocular Decompression With Cotton Swabs Lowers Intraocular Pressure Elevation After Intravitreal Injection

Gregori

Weiss

Goldhardt

et al. 2014

Journal of Glaucoma

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“…Approximately 65% of studies (n=44/67) were retrospective in design with follow-up periods of more than 6 months reported in less than a third (n=18/67) of included studies. Baseline characteristics of participants were comparable in two non-randomised studies28 29 and three case-control studies 30–32…”

Section: Resultsmentioning

confidence: 99%

The safety of intravitreal bevacizumab monotherapy in adult ophthalmic conditions: systematic review

et al. 2014

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ObjectivesTo assess the safety of intravitreal bevacizumab (IVB) as a monotherapy and to evaluate the relationship between quality of treatment and adverse events.Data sourcesCochrane Library, Ovid MEDLINE, MEDLINE in-process, Ovid EMBASE and Toxicology Literature Online (TOXLINE) from January 2009 to May 2012. Studies included in an earlier systematic review were also assessed for inclusion.Study eligibility criteria, participants and interventionsRandomised controlled trials (RCTs), controlled trials or observational studies including ≥10 participants reporting adverse events data following IVB monotherapy as a primary treatment in patients (aged 18 years or more) with any eye condition were included.Study appraisal and synthesis methodsStudy selection was undertaken independently by a minimum of two reviewers using pre-defined criteria. Data abstraction and quality assessment were performed by one reviewer, and then checked by a second reviewer. Study quality was assessed for only RCTs in accordance to the Cochrane Risk of Bias Tool. Additional items relating to safety data were also assessed. Results were tabulated or meta-analysed as appropriate.Results22 RCTs and 67 observational studies were included. Only two RCTs reported valid safety data. Rates of serious adverse events following treatment were low. There was insufficient data to explore the relationship between the incidence of adverse events and quality of IVB injection.LimitationsA majority of relevant existing studies were characterised by small sample sizes, unclear diagnostic criteria and reporting of safety outcomes.Conclusions and implications of key findingsAvailable evidence demonstrates low rates of serious local and systemic adverse events following treatment. However, the role of IVB quality in the incidence of adverse events remains unclear. Robust evidence is needed to examine the relationship between the incidence of adverse events and variables such as injection techniques, pre-existing risk factors (eg, immunosuppression, cross-contamination) and quality of IVB treatment.

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“…In addition to monitoring the amount of postinjection reflux, other groups have also suggested lowering preinjection IOP with glaucoma drops 27 or softening the eye with pressure during anesthetic preparation of the globe 28,29 to reduce the levels of immediate postinjection IOP. Based on our analysis, the presence of a PVD increased the likelihood of postinjection reflux.…”

Section: Discussionmentioning

confidence: 99%

Influence of Axial Length and Postinjection Reflux on Sustained Intraocular Pressure Elevation as a Result of Intravitreal Anti–vascular Endothelial Growth Factor Therapy

Hoang

Jung

Mrejen

et al. 2014

Retina

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Effect of the Honan intraocular pressure reducer on intraocular pressure increase following intravitreal injection using the tunneled scleral technique

Abstract: The use of the HIPR reduces the IOP after an intravitreal injection using the tunneled scleral technique. However, the HIPR does not appear to affect a reduction in the vitreous reflux.

Cited by 18 publications

References 31 publications

Ocular Decompression With Cotton Swabs Lowers Intraocular Pressure Elevation After Intravitreal Injection

Ocular Decompression With Cotton Swabs Lowers Intraocular Pressure Elevation After Intravitreal Injection

The safety of intravitreal bevacizumab monotherapy in adult ophthalmic conditions: systematic review

Influence of Axial Length and Postinjection Reflux on Sustained Intraocular Pressure Elevation as a Result of Intravitreal Anti–vascular Endothelial Growth Factor Therapy

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