Reduction of pegaptanib loss during intravitreal delivery using an oblique injection technique

To develop an injection technique that reduces drug loss occurring due to reflux and consequent subconjunctival bleb formation after standard intravitreal pegaptanib injection.

Prospective interventional case series report. The 27-gauge needle is inserted obliquely via pars plana to create a valved wound. The rate of subconjunctival bleb formation is evaluated performing ultrasound biomicroscopy, (1/2)h after intravitreal drug delivery comparing standard (straight)with this new described injection technique (oblique) using Fisher's exact test.

Eyes on which oblique injection technique was performed developed significantly less subconjunctival bleb than those treated with the standard technique. The rate of injection-related complications (retinal detachment, vitreous haemorrhage, traumatic cataract, and endophthalmitis) in our small series was similar between both groups.

The use of this technique can result in reduced drug loss after intravitreal pegaptanib injection. Larger studies are needed to determine if the rate of complications associated with intravitreal injections, especially endophthalmitis, is lowered with this technique.