The Effects of Injection Site on the Reflux Following Intravitreal Injections

BACKGROUND This study aimed to investigate the effects of injection site on the reflux after intravitreal injection. METHODS One hundred and eighty eyes undergoing intravitreal injection including 0.1 ml of triamcinolone acetonide or bevacizumab or pegaptanib were divided to six groups (30 patients in each group) to compare the vitreal reflux after injection using superotemporal versus inferotemporal quadrant. The amount of intraoperative reflux was estimated by measuring the width of the subconjunctival bleb. An interventional, prospective, comparative clinical trial was applied. RESULTS The mean bleb width as the reflux amount after injection of three drugs was statistically less after the inferotemporal injection (1.50 ± 0.94 mm for triamcinolone acetonide, p < 0.001; 1.60 ± 1.07 mm for bevacizumab, p < 0.001; and 1.77 ± 0.94 mm for pegaptanib, p = 0.001) than those in eyes undergoing the superotemporal injection (3.20 ± 1.63 mm for triamcinolone acetonide; 3.07 ± 1.53 mm for bevacizumab; and 2.80 ± 1.32 mm for pegaptanib). CONCLUSIONS The injection through inferotemporal quadrant provides statistically significant less vitreal reflux for intravitreal drug injection. KEYWORDS Intravitreal injection; Injection site; Reflux.