No difference in pain reported with smaller-gauge intravitreal injection needle

PHILADELPHIA — Patients who received intravitreal injections experienced no less pain with a slightly smaller diameter needle, according to a study presented by Christopher M. Aderman, MD, at the Wills Eye Conference.

In the randomized, prospective study, 49 patients underwent bilateral same-day injections of Eylea (aflibercept, Regeneron) or Lucentis (ranibizumab, Genentech), and pain scores were compared with a 30-gauge needle vs. a 33-gauge needle.

The 30-gauge needles, which are standard and packaged with the drugs, have an outer diameter of 0.31 mm, while the 33-gauge needles have a diameter of 0.21 mm, a 32% reduction in size, Aderman said.

Each subject received the first injection in the right eye, with the needle size randomly chosen, and the contralateral eye received the other size needle. Subjects were asked to rate their pain after each injection using a scale of 0 to 10.

The average score was 3.1 for the 30-gauge needle and 2.7 for the 33-gauge needle, which was not a statistically significant difference, according to Aderman.

“There’s no difference in pain scores between 33- and 30-gauge needles and no difference in our post hoc analysis of age, gender or diagnosis,” he said. “Ultimately, patient discomfort during intravitreal injection is multifocal.”

In addition, the cost of the smaller-gauge needles may be prohibitive, with the 30-gauge priced at $0.15 each and the 33-gauge priced at $0.50 each, Aderman said. – by Rebecca L. Forand

Reference:

Aderman CM. Comparing patient experience during intravitreal injections with 33-gauge versus 30-gauge needles. Presented at: Wills Eye Conference; March 8 to 10, 2018; Philadelphia.

Disclosure: Aderman reports no relevant financial disclosures.