Tunneled scleral incision to prevent vitreal reflux after intravitreal injection

To investigate the efficacy of tunneled scleral incision compared with standard straight scleral incision to prevent vitreal reflux after intravitreal (IVT) injection.

Prospective comparative controlled nonrandomized clinical study.

Eighty-eight eyes undergoing IVT-injection were allocated into four groups to compare the vitreal reflux after injection of 0.1 ml of triamcinolone acetonide (TA) and Avastin using a tunneled vs straight injection technique. The amount of intraoperative drug reflux was estimated by measuring the width of the subconjunctival bleb.

The mean measured reflux of volume was statistically less with the tunneled scleral incision (1.13 mm standard deviation [SD] +/- 1.16 for TA; 1.13 mm SD +/- 1.39 for Avastin) than in eyes undergoing the straight scleral injection (3.00 mm SD +/- 1.77 for TA; 3.18 mm SD +/- 1.68 for Avastin) for both Avastin and TA IVT-injections groups (P < .001).

The tunneled scleral incision promotes statistically significant less vitreal reflux for IVT drug injection.