Ocular decompression with cotton swabs lowers intraocular pressure elevation after intravitreal injection.

Abstract

OBJECTIVE To determine the effect of preinjection 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 2 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 mm Hg. The IOP elevations from baseline were compared after the 2 anesthetic methods. RESULTS The preinjection mean IOP (SD, mm Hg) was 15.5 (3.3) before the cotton swabs and 15.9 (3.0) before the gel (P=0.28). Mean IOP (SD, mm Hg) 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 mm Hg compared with only 10% of cotton swab eyes immediately after the injection (P<0.001). CONCLUSION Decompressing the eye with cotton swabs during anesthetic preparation before an intravitreal injection produces a significantly lower IOP spike after the injection.

DOI: 10.1097/IJG.0b013e318294865c

Cite this paper

@article{Gregori2014OcularDW, title={Ocular decompression with cotton swabs lowers intraocular pressure elevation after intravitreal injection.}, author={Ninel Z. Gregori and Matthew J. Weiss and Raquel Goldhardt and Joyce C Schiffman and Edgardo Vega and C Mattis and Wei Lin Shi and Linda L. Kelley and Vilma Hernandez and William J Feuer}, journal={Journal of glaucoma}, year={2014}, volume={23 8}, pages={508-12} }