Survey of Intravitreal Injection Techniques Among Retina Specialists in Mexico

Figures & data

Table 1 Comparison of Intravitreal Injection Practice Patterns Between This Study and Previous Studies

	Canada 2014 Xing et al^Citation8	USA & others 2019 Uhr et al^Citation7	USA 2019 Chaturvedi et al^Citation6	Israel 2016 Segal et al^Citation9	India 2020 Sundar et al^Citation10	Brazil 2015 Shiroma et al^Citation11	Europe 2016 Huang et al^Citation20	Mexico 2020 Henaine-Berra et al (current study)
Number of participants (Survey response rate)	75 (64%)	399 (14%)	281 (17%)	52 (66%)	741 (73%)	352 (38%)	113 (90%)	133 (78%)
Pre-IVI procedures
Setting
Physician’s office	72%	72%	N/A	N/A		5%	3.5%	21%
Procedure room	N/A	23%			8%	7%		45%
Operating room	28%	5.5%			91%	88%	68%	34%
Simultaneous bilateral injections	57%	71.5%	45%	56%	N/A	36%	N/A	12%
Pre-IVI antibiotics	20%	11%	21%	N/A	60%	N/A	67%	22%
Face mask	29%	33%	36%	37%	98%	N/A	N/A	97%
Gloves	39%	55%	73%	79%	98%	95%	75%	91%
Lid speculum	91%	72%	66%	98%	96%	95%	81%	83%
Anesthesia	Drops combined with other methods: 90% Drops only:29% Gel: 25% Swab: 23% SC: 23%	Drops:63% Gel: 32% SC: 27% Swab: 19% Others: 3%	Gel with or without drops: 31% SC with or without drops: 27% Drops only: 16% Drops + swab: 14%	Drops+gel: 67% Drops only: 25% Gel only: 8%	Local anesthesia:91%	Drops only: 67% Drops + gel: 20%, Peribulbar: 3%	N/A	Drops: 97% SC: 2% Gel: 1%
Antisepsis	PI: 100%	PI: 97.5% Clorhexidine:2%	PI: 100%	N/A	N/A	PI:99%	PI:90%	PI:100%
Injection technique
Quadrant
Superotemporal	43%	OD 32% OS 30%	27%	33%	N/A	N/A	N/A	63%
Inferotemporal	63%	OD 62% OS 61%	70%	17%	N/A	N/A	N/A	35%
Superonasal	7%	OD 1.5% OS 4%	0%	6%	N/A	N/A	N/A	2%
Inferonasal	7%	OD 5% OS 5%	4%	4%	N/A	N/A	N/A	0%
Measurement of distance from corneal limbus to site of puncture	56%	30.5%	20%	69%	N/A	80%	N/A	80%
Needle gauge for intraocular injection
25 G	N/A	N/A	NE	0	N/A	N/A	N/A	3%
27 G	N/A	N/A	1%	4%	N/A	N/A	N/A	15%
30 G or more	N/A	N/A	89%	90%	N/A	48%	N/A	82%
Method for preventing vitreous reflux
Swab	41%	N/A	37%	N/A	N/A	N/A	N/A	80.5%
Angled scleral tunnel technique	7%	N/A	N/A	N/A	N/A	30%	N/A	N/A
Conjunctival displacement	11%	20.1%	N/A	21%	N/A	58%	N/A	N/A
None	40%	N/A	N/A	N/A	N/A	N/A	N/A	19.5%
Post-IVI procedures
Use of antibiotics post-IVI	20%	17% Always or often instills antibiotics immediately after injection, 9% Always or often prescribes antibiotics for home use	28%	92%	89% for several days	89% for several days	89.5%	59% for several days, 18% one drop immediately after injection
AC paracentesis (pre or post injection)	51%	14% in patients with advanced glaucoma	10% performed 25% of the time	27% in cases of end-stage glaucoma	N/A	Always performed:11% Performed when necessary: 54%	N/A	2%
Verify optic nerve perfusion	48%	56%	4% checked for visual acuity	44%	N/A	25%	N/A	53% checked counting fingers visual acuity

Abbreviations: N/A, not available; PI, povidone-iodine; AB, antibiotics; SC, sub-conjunctival, AC, anterior chamber.

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