Título / Title

SILICONE OIL DROPLETS IN THE VITREOUS AFTER INTRAVITREAL INJECTION WITH A SILICONE OIL-FREE AND A SILICONIZED INSULIN SYRINGE: A RANDOMIZED CONTROLLED TRIAL

Introdução / Purpose

This study aimed to compare the incidence and quantity of intravitreal silicone oil following intravitreal bevacizumab injections using silicone oil-free syringes versus conventional siliconized syringes.

Material e Método / Methods

A blinded randomized clinical trial was conducted involving IVI-naïve diabetic subjects. Participants received six monthly IVIs of bevacizumab and were randomly assigned to receive injections using either a silicone oil-free syringe (ZR-SF group) or a siliconized syringe (BD-UF group). The presence and quantity of intravitreal silicone oil were assessed, along with WHO Five Well Being Index, Frankfurt Floater Questionnaire, reported pain, hyperemia, anterior chamber reaction and intraocular pressure.

Resultados / Results

Fifty-five eyes completed the study (29 in ZR-SF and 26 in BD-UF groups). The mean age was 60.07 ± 9.18 years in ZR-SF and 62.73 ± 8.1 in BD-UF. Right eyes comprised 55.17% in ZR-SF and 38.46% in BD-UF. Silicone oil was detected at any time point in 64% of ZR-SF patients and 96% of BD-UF patients (p = 0.016). The maximum silicone oil amounts at any time point were as follows: ZR-SF—0 (37.93%), +0.5 (10.34%), +1 (37.93%), +2 (10.34%), +3 (3.45%), and +4 (none); BD-UF—0 (3.85%), +0.5 (11.54%), +1 (15.38%), +2 (30.77%), +3 (19.23%), and +4 (19.23%) (p < 0.01). Furthermore, 86.21% of ZR-SF eyes had +1 or less silicone oil, compared to 30.77% in BD-UF (p=0.001). No significant differences were observed between the groups regarding floater symptoms, anterior chamber cells, pain, and hyperemia.

Discussão e Conclusões / Conclusion

The Zero Residual Silicone Oil-Free syringe showed a reduced presence of silicone oil in the vitreous compared to siliconized syringes, without significant differences in secondary outcomes. These findings support the use of silicone oil-free syringes to mitigate silicone oil-related complications following IVIs.

Palavras Chave

Intravitreal Injections, Silicone Oils, Uveitis, Diabetic Retinopathy, Syringes

Area

CLINICAL RETINA

Institutions

Hospital de Olhos de Sergipe - Aracaju - Sergipe - Brasil, Universidade Federal de São Paulo - São Paulo - São Paulo - Brasil

Authors

MATEUS LINS DOS SANTOS, LYDIANNE LUMACK MONTE AGRA, VIVIANE SANTOS CARDOSO, EDGAR MENEZES NETO, FERNANDA MOTA MAGALHÃES, GUSTAVO BARRETO DE MELO