Hafsa Malik, Imran Saleem Channar.
Proparacaine as a Topical Anaesthetic for intravitreal (IVT) injections.
Ophthalmol Update Jan ;15(3):223-6.

Objective: To evaluate the efficacy of Proparacaine 0.5% as a topical anesthetic during intra-vitreal (IVT) injection procedures. Study Design: Quasi-Experimental study. Place and Duration: Eye Unit-II, Bahawal Victoria Hospital, Bahawalpur, from December 2016 to April 2017. Methodology: Thirty patients (30) needing IVT bevacizumab for macular edema (ME) secondary to diabetic retinopathy (DR) and retinal vein occlusion (RVO) were administered IVT injection under topical anesthesia using proparacaine 0.5% eye drops. IVT injections were performed using sterile technique. Each patient was instilled a drop of proparacaine eye drops 4-5 times before administering the injection. 0.5ml (1.25mg) of the bevacizumab solution was injected into the core vitreous. Once the IVT injection had been administered, each patient was asked about the intensity of ocular pain and discomfort experienced during the procedure. A grading scale based on pain score called Visual Analog Scale (VAS) was used to evaluate the subjective pain experienced by the patients. Computer software SPSS (version 10) was used to analyze the data. Results were considered statistically significant at p<0.05. Results: It was possible to perform all the IVT injection procedures under topical anesthesia using 0.5% Proparacaine eye drops without a need for supplemental subconjunctival (SC) or peri/retrobulbar injections. Pain reported by the patients, as recorded on a Visual Analog Scale (VAS), was mild to moderate in majority of the patients. Conclusion: Topical proparacaine 0.5% is a safe and effective anesthetic during IVT injection procedures. The optimal intensity and duration of anesthesia produced by this anaesthetic agent permits performing the IVT injections with low subjective pain and a resultant better patient compliance.

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