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Cooling Anesthesia for Intravitreal Injection: Results of the Prospective Open-Label, Dose-Ranging COOL-1 Trial
Daniel L Chao1, Nicolas T Rinella1, Arshad M Khanani2
1Viterbi Family Department of Ophthalmology, University of California, San Diego, CA, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|December 17, 2021
Summary
A novel cooling anesthesia device safely reduced pain during intravitreal injections. This rapid cooling method provided effective local anesthesia without serious ocular side effects.
Area of Science:
- Ophthalmology
- Anesthesiology
- Medical Device Technology
Background:
- Intravitreal injections require effective local anesthesia to minimize patient discomfort.
- Current anesthesia methods may have limitations in speed or efficacy.
- Novel approaches to ocular surface cooling are being explored for procedural anesthesia.
Observation:
- A first-in-human, open-label study evaluated a new cooling device for ocular anesthesia.
- 43 subjects received intravitreal injections with cooling anesthesia at varying temperatures and durations.
- Pain was assessed using a Numeric Rating Scale (NRS).
Findings:
- The cooling anesthesia device was safe, with no serious ocular adverse events reported.
- One vasovagal response occurred but resolved quickly.
- Mean NRS pain scores ranged from 2.5 to 4.3, indicating moderate pain levels.
- Statistically significant decreases in pain were observed post-injection and up to 48 hours later.
Implications:
- This cooling device offers a safe and well-tolerated option for local anesthesia in ophthalmology.
- It demonstrates potential for improving patient experience during intravitreal injections.
- Further research may explore optimized cooling parameters for enhanced pain reduction.
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