To compare accuracy, precision, and residual volume<\/a> of commonly used syringes for intravitreal injections<\/a> (IVIs) and to assess the intraocular pressure<\/a> (IOP) rise by variations in volumes delivered.<\/p>\n\n\n\n Experimental laboratory study.<\/p>\n\n\n\n No subjects were involved in this study.<\/p>\n\n\n\n We tested 8 syringe models with 2 different needle setups, with 2 different solutions (distilled water or glycerin) and target volumes (50 and 70 \u03bcL). To obtain the delivered and residual volumes, we weighed the syringe-needle setups with scale before liquid withdrawal, with liquid, and after liquid release. We also created an experimental eye model to determine the transient rise in IOP following stepwise 10-\u03bcL increases in injection volumes.<\/p>\n\n\n\n Delivered and residual volumes, IOP rise.<\/p>\n\n\n\n We tested a total of 600 syringe-needle setups. Becton Dickinson (BD) Ultra-Fine (0.34 \u00b1 0.28 \u03bcL), Zero Residual (1.53 \u00b1 1.15 \u03bcL), and Zero Residual Silicone Oil-free (1.40 \u00b1 1.16 \u03bcL) syringes showed the lowest residual volume (P<\/em> < 0.001) in comparison with the others (range: 24.86 \u00b1 1.78 \u03bcL for Injekt-F to 51.97 \u00b1 3.37 \u03bcL for Omnifix-F). The most accurate setups were (percentage deviation from target volume): Zero Residual Silicone Oil-free (+ 0.70%), Zero Residual 0.3 ml (+ 4.49%), BD Ultra-Fine (+ 7.83%), Injekt-F (9.42%), Norm-Ject (+ 15.88%), Omnifix-F (+ 16.96%), BD Plastipak Brazil (+17.96%), and BD Plastipak Spain syringes (+ 19.41%). There was a statistically significant difference between the Zero Residual Silicone Oil-free syringe and all other syringes (P<\/em> < 0.0001), except for the Zero Residual 0.3-ml syringe (P<\/em> = 0.029). The coefficient of variation was low for all syringes. The modeled IOP rise ranged from 32.3 (standard deviation [SD], 1.4) mmHg for 20-\u03bcL injection volume to 76.5 (SD, 1.0) mmHg for 80-\u03bcL injection volume. For the standard 50-\u03bcL injection volume, the peak pressure was 50.7 (SD, 0.1) mmHg, and the pressure rise duration was 28 (SD, 2) minutes.<\/p>\n\n\n\n There were significant differences in accuracy and residual volume between syringes, whereas they showed a high precision. Volume excess results in a considerable increase in IOP rise after injection. These findings may provide a relevant overview to clinicians and to both device and drug<\/a> manufacturers regarding pharmacoeconomic, safety, and efficacy issues.<\/p>\n\n\n\n Proprietary or commercial disclosure may be found after the references.<\/p>\n\n\n\n Accuracy, Anti-VEGF, Intraocular pressure, Intravitreal injection, Residual volume, Syringe<\/p>\n\n\n\n BD: Becton Dickinson<\/p>\n\n\n\n IOP: intraocular pressure<\/p>\n\n\n\n IVI: intravitreal injection<\/p>\n\n\n\n SD: standard deviation<\/p>\n\n\n\n <\/p>\n\n\n\nDesign<\/h3>\n\n\n\n
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