Medical Retina Feature Story

APRIL 2010 I RETINA TODAY I 59 I ntravitreal injection has become one of the most commonly performed vitreoretinal procedures, but there is little agreement in the retina community regarding what type of topical anesthetic is most effective for it. We performed a study to assess the effectiveness of gel vs liquid topical anesthetics for this application.1 This prospective, single-center study included 86 patients receiving either 30-gauge or 31-gauge intravitreal injections. A single physician (JSP) administered the anesthetic and performed the injection procedure. The patients were randomly assigned to one of three topical anesthetic groups prior to injection: 0.5% proparacaine HCl (Akorn, Inc.; Group 1); 0.5% proparacaine HCl plus a pair of 4% lidocaine-soaked cotton-tip swabs applied to the injection site for 20 seconds (Group 2); or 3.5% lidocaine HCl ophthalmic gel (Akten, Akorn, Inc.; Group 3). Statistical analysis was performed using Kruskal Wallis one-way analysis of variance. Excluded were patients who were receiving injections associated with management of endophthalmitis or retinal detachment, who were unable to comprehend the pain scale that was used to grade discomfort, or who were under 18 years of age. Patient Assessment: Gel vs Liquid Anesthetic for Intravitreal Injections