Evaluation of ocular pain after different application techniques of topical proparacain 0.5% drops for intravitreal injections
Journal Title: Medpulse International Journal of Ophthalmology - Year 2018, Vol 7, Issue 2
Abstract
Aim: To evaluate ocular pain after different application techniques of topical proparacain 0.5% drops for ntravitreal injections Materials and methods: A prospective, non randomized, single centre and surgeon, crossover comparative study was done in consecutive 36 patients undergoing multiple intravitreal injection of ranibizumab 0.05ml in the same eye for various retinal pathologies. All the patients were explained about VAS pain score (0 to10 scale). Topical proparacaine 0.5% was instilled prior and after sterile draping and wire speculum application. After 5 minutes, topical povidone iodine 5% was instilled. Pain score was measured using VAS analogue immediately after intravitreal injection. Same procedure was followed for monthly second dose of intravitreal injection except for addition of local application of pledget soaked in topical proparacaine 0.5% at the site of injection for 5 minutes prior instillation of topical povidone iodine 5% and VAS score was recorded immediately after the procedure. Results: Mean vas score after first injection was 5.16 with 1.38 standard deviation (SD) with range from (2-8). Mean pain score for the second injection was 0.05 (sd 0.23) with range from (0-1). Median pain score was 5 after first injection while it was 0 after second injection. Pledget application technique was significantly better in achieving painless procedure (unpaired t test p<0.001). 31/36 (86%) patients required oral NSAID while none required after giving the second injection. Conclusion: Addition of local application of pledget soaked in proparacaine in patients undergoing intravitreal injection under topical instillation of proparacaine significantly reduces perceived ocular pain during intravitreal injections.
Authors and Affiliations
Sheshadri Mahajan
Keywords
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