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[Translated article] Syringes for intraocular administration: A systematic review.

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Syringes for intraocular administration: Systematic review.

Ángela Pascual Carrasco1, Isabel Espadas García1, Ana Ramírez López1

  • 1Servicio de Farmacia, Hospital General Universitario Doctor Balmis, Alicante, España.

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Summary

Concerns about silicone oil in intravitreal injections are driving the need for specialized, silicone-free syringes for intraocular use. New ophthalmic syringes are expected to be available soon, improving patient safety and regulatory compliance.

Keywords:
Aceite de siliconaAgujaIntraocular injectionIntravitreal injectionInyección intraocularInyección intravítreaJeringaNeedleOff-Label useSilicone oilSyringeUso Off-Label

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Area of Science:

  • Ophthalmology
  • Medical Device Engineering
  • Pharmacology

Background:

  • Off-label use of non-approved syringes for intravitreal drug administration has led to silicone oil droplets in patients' eyes.
  • A lack of approved intraocular syringes in the Spanish market necessitates a review of current practices and alternatives.
  • Silicone oil contamination poses risks, including adverse reactions, impacting patient ocular health.

Purpose of the Study:

  • To review the use of syringes for intraocular drug administration.
  • To identify and evaluate alternative syringes that meet legal requirements for intravitreal injections.
  • To address the unmet need for approved, silicone-free syringes in the Spanish market.

Main Methods:

  • A systematic review was conducted following PRISMA 2020 Guidelines.
  • PubMed searches included terms like "silicone," "syringes," and "intraocular" or "intravitreal" from January 2006 to December 2023.
  • Analysis focused on articles detailing silicone oil release in intravitreal injections and potential consequences.

Main Results:

  • A total of 45 articles were included in the systematic review after excluding 23 irrelevant results.
  • Articles were categorized into adverse reactions, administration techniques, silicone release, and device characteristics.
  • Two likely silicone-free syringes for ophthalmic use, Zero Residual™ 0.2 ml SiO-free and VitreJect® Ophthalmic, are expected in Spain by early 2024.

Conclusions:

  • The use of silicone-containing syringes for intravitreal injections is a significant concern for healthcare professionals due to potential adverse patient reactions.
  • The development and availability of silicone-free syringes specifically designed for intraocular use are crucial.
  • Ensuring safety and legal compliance in the use of intraocular syringes and needles is paramount for maintaining ocular integrity and patient well-being.