Patients’ tolerance of bimanual lid retraction versus a metal speculum for intravitreal injections

OBJECTIVE To compare patients' acceptance of and correlate their pain level for bimanual versus metal speculum fixation in intravitreal injections. DESIGN Prospective analysis. PARTICIPANTS Seventy-three eyes of 56 patients. METHODS A questionnaire indicating patients' discomfort and pain grading immediately after intravitreal injections using either bimanual fixation or metal speculum fixation (Barraquer Wire Speculum). RESULTS Fifty-six patients who underwent intravitreal injections were enrolled in this study for various conditions. Patients' overall pain and discomfort were as follows, right eye - bimanual was 0.3 on our grading scale with a standard deviation of 0.54, right eye - metal was 1.6 on our grading scale with a standard deviation of 1.5, left eye - bimanual was 0.41 on our grading scale with a standard deviation of 0.87, and left eye - metal was 1.91 on our grading scale with a standard deviation of 1.14 (P=0.003). CONCLUSION Patients who underwent bimanual fixation had a much more comfortable experience with less pain in comparison to patients who underwent metal speculum fixation.