Preoperative Educational Video Viewing is Associated with a Reduced Incidence of Subconjunctival Hemorrhage Following...

To assess whether preoperative viewing of an educational procedural video reduces the incidence and severity of subconjunctival hemorrhage (SCH) following intravitreal anti-VEGF injections (IVI), and improves patient experience.

In this surgeon-blind randomized controlled trial conducted at a single tertiary care center (NCT07002372), treatment-naïve patients scheduled for their first IVI were prospectively enrolled and randomized to either an intervention group (video viewing) or a control group (no video viewing). All participants completed the State-Trait Anxiety Inventory-State (STAI-S) before and after the injection. SCH incidence and area were assessed via standardized post-injection photographs analyzed using ImageJ software. Additional outcomes included patient-reported pain scores, heart rate, procedure time, and surgeon-rated cooperation.

A total of 108 patients were enrolled, of whom 103 completed the study, which was fewer than the initially planned sample size. Baseline demographics were similar between groups. SCH occurred in 21/51 (41.2%) patients in the intervention group versus 36/52 (69.2%) in the control group (P = 0.004), though SCH area did not differ significantly. Logistic regression analysis revealed that the use of anticoagulant medication was positively associated with the occurrence of SCH (OR = 3.252; 95% CI, 1.166-9.071; P = 0.024), whereas watching an educational video prior to IVI was associated with a lower risk of SCH (OR = 0.275; 95% CI, 0.115-0.656; P = 0.004). Anxiety scores decreased post-procedure in both groups. In the intervention group, anxiety decreased modestly after video viewing (28.54 ± 10.40 to 27.00 ± 8.78, P = 0.052). Patients rated the video as helpful for understanding (8.75/10), calming nerves (8.44/10), and improving cooperation (8.55/10). No significant differences were observed in pain scores, heart rate, procedure time, or surgeon-rated cooperation.

Preoperative procedural video viewing reduces the incidence of SCH and improves patients' understanding of IVI. Given its simplicity and ease of implementation, this approach may serve as a practical adjunct to enhance patient experience in clinical practice.