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RANDOMIZED TRIAL OF ANESTHETIC METHODS FOR INTRAVITREAL INJECTIONS

Blaha, Gregory R MD, PhD; Tilton, Elisha P MD; Barouch, Fina C MD; Marx, Jeffrey L MD

doi: 10.1097/IAE.0b013e3181eac724
Original Study
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Purpose: To compare the effectiveness of four different anesthetic methods for intravitreal injection.

Methods: Twenty-four patients each received four intravitreal injections using each of four types of anesthesia (proparacaine, tetracaine, lidocaine pledget, and subconjunctival injection of lidocaine) in a prospective, masked, randomized block design. Pain was graded by the patient on a 0 to 10 scale for both the anesthesia and the injection.

Results: The average combined pain scores for both the anesthesia and the intravitreal injection were 4.4 for the lidocaine pledget, 3.5 for topical proparacaine, 3.8 for the subconjunctival lidocaine injection, and 4.1 for topical tetracaine. The differences were not significant (P = 0.65). There were also no statistical differences in the individual anesthesia or injection pain scores. Subconjunctival lidocaine injection had the most side effects.

Conclusion: Topical anesthesia is an effective method for limiting pain associated with intravitreal injections.

Four types of anesthetics for intravitreal injection (proparacaine, tetracaine, lidocaine pledget, and subconjunctival injection of lidocaine) were studied in a prospective, masked, randomized block design. Pain was graded by the patient on a 0 to 10 scale for both the anesthesia and the injection. There was no statistical difference between the anesthetic methods.

From the Lahey Clinic, Peabody, Massachusetts.

The authors have no conflicts of interest relevant to this article to disclose.

Dr. Blaha is on the Speaker's Bureau and has attended advisory boards for Genentech.

Dr. Marx has attended advisory boards for Genentech.

Reprint requests: Gregory R. Blaha, MD, PhD, Lahey Clinic, 1 Essex Center Drive, Peabody, MA 01960; e-mail: gregory.r.blaha@lahey.org

© The Ophthalmic Communications Society, Inc.