A novel device for rapid, safe and precise delivery of intravitreal injections. Issue 1 (11th April 2019)

• Record Type: Journal Article
• Authors: Waqar, Salman; Ayaz, Ali; Karamat, Irfan; Anwar, Saba; McLeod, James; McLeod, Alan
• Is Part Of: BMJ innovations. Volume 5:Issue 1(2019)
• Page Start: 8
• Page End: 12
• Publication Date: 2019-04-11
• Subjects: intravitreal injections -- ophthalmology -- patient safety -- innovation -- National Health Service; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjinnov-2018-000337
• Languages: English
• ISSNs: 2055-8074

Abstract

Abstract : Background: Delivery of therapeutic agents via intravitreal (IVT) injections is well established as the mainstay of treatment for many ophthalmic conditions. High demand means that injections are increasingly being delivered either by ophthalmic nurse practitioners (UK) or by ophthalmologists in office-based settings (North America/mainland Europe). Most patients require frequent IVT injections, and there is a need to make the procedure more comfortable and safe. Methods: We describe a novel device designed to ensure rapid, safe and precise delivery of injections while improving the patient experience. In addition, we present details of a local National Health Service pathway initiated to facilitate clinician-led innovations. It is hoped that this model can also be replicated internationally. We also present results from two sites: one, comparing outcomes of 25 patients who received the injection with the device, against 25 patients who received injections using the current standard method; the other a retrospective notes evaluation of 60 patients injected with the device. Results: No adverse events were noted and the device appears to be well tolerated by patients. Use of the guide did not result in a statistically significant increase in pain (p value > 0.05) but the mean score (on a unidimensional numerical rating scale) was noted to be slightly better. All patients gave very positive informal feedback. Conclusions: We have described the design process and successful early-use results of a novel device developed to facilitate safe, precise and rapid delivery of IVT injections by both ophthalmologists and allied health professionals.