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An Alternative and Validated Injection Method for Accessing the Subretinal Space via a Transcleral Posterior Approach
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Patient Reported Experiences and Comfort Associated with Intravitreal Injection Technique: A Cross-Sectional Survey

Elahhe R Afkhamnejad1, Zainub A Abdullah1, Orion M Q Nguyen2

  • 1University of Texas Medical Branch Galveston, Galveston, TX, USA.

Journal of Vitreoretinal Diseases
|November 3, 2025
PubMed
Summary
This summary is machine-generated.

Most patients tolerate intravitreal anti-VEGF injections well, reporting minimal discomfort and side effects. Patient preferences favor specific techniques like manual lid retraction and Betadine-soaked cotton tips for improved comfort during these vital eye treatments.

Keywords:
anti-VEGF agentsdiabetic macular edemapatient satisfactionproliferative diabetic retinopathywet AMD (neovascular)

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Area of Science:

  • Ophthalmology
  • Patient Experience Research
  • Medical Device & Technique Analysis

Background:

  • Intravitreal anti-VEGF injections are crucial for treating various retinal diseases.
  • Understanding patient comfort and preferences is key to improving treatment adherence and outcomes.
  • Variations in injection techniques may influence patient experience and reported side effects.

Purpose of the Study:

  • To evaluate patient experiences and preferences regarding intravitreal anti-VEGF injection techniques.
  • To identify specific aspects of the injection process that contribute to patient discomfort or satisfaction.
  • To compare patient-reported outcomes across different methods of anesthesia, lid retraction, and antiseptic application.

Main Methods:

  • A survey was administered to 1111 patients undergoing anti-VEGF injections across five clinic locations.
  • Statistical analyses including t-tests, ANOVA, and Tukey-Kramer tests were used to compare patient responses.
  • Data collected included ratings of discomfort, preferences for specific techniques, and reported side effects.

Main Results:

  • Patients reported low overall discomfort (mean VAS < 2/10).
  • Lidocaine pledgets were associated with higher discomfort (P < .05), while manual lid retraction was preferred over speculums (P = .0017).
  • Betadine-soaked cotton tips were preferred over drops or swabs; common complaints included inadequate anesthesia and Betadine irritation.

Conclusions:

  • Intravitreal anti-VEGF injections are generally well-tolerated with minimal side effects.
  • Patient preferences lean towards topical gel or subconjunctival anesthesia, manual lid retraction, and Betadine-soaked cotton tips.
  • Further research into the safety of preferred techniques is warranted.