RT Journal Article
SR Electronic
T1 Release of silicone oil and the off-label use of syringes in ophthalmology
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 291
OP 296
DO 10.1136/bjophthalmol-2019-313823
VO 104
IS 2
A1 Gustavo Barreto Melo
A1 Geoffrey Guy Emerson
A1 Celso Souza Dias Jr
A1 Fábio Barreto Morais
A1 Acacio de Souza Lima Filho
A1 Shoko Ota
A1 Michel Eid Farah
A1 Eduardo Büchele Rodrigues
A1 Maurício Maia
A1 Rubens Belfort Jr
YR 2020
UL http://bjo.bmj.com/content/104/2/291.abstract
AB Background/aims To assess silicone oil (SO) release by different brands of syringes used for intravitreal injection under different handling conditions.Methods Eight syringes were analysed: from the USA, Terumo 0.5 mL, Becton-Dickinson (BD) Tuberculin 1 mL, BD Luer-lok 1 mL, BD Ultra-Fine 0.3 mL and Exel Insulin 0.3 mL; from Germany, Braun Omnifix-F 1 mL and Braun Injekt-F 1 mL and from Spain, BD Plastipak 1 mL. The impact of air, priming the plunger, agitation by flicking and fluid temperature on SO release were assessed by light microscopy. Fourier transform infrared spectroscopy (FTIR) was performed to identify the molecular compound in each syringe.Results Five hundred and sixty syringes were analysed. Terumo 0.5 mL and BD Ultra-Fine 0.3 mL released more SO than all others. BD Luer-lok 1 mL, BD Plastipak and Braun Omnifix-F 1 mL released little SO; BD Tuberculin 1 mL, Exel 0.3 mL and Braun Injekt-F 1 mL released the least SO. Priming the syringe and different temperatures did not significantly affect SO release. Agitation by flicking caused a significantly higher proportion of samples to have SO droplets and an increased number of oil droplets. Air had an additive effect on the release of oil in the agitation groups. FTIR identified polysiloxane in all syringes but Injekt-F.Conclusion Syringes commonly used for intravitreal injections frequently release SO droplets, especially when agitated by flicking. To avoid unnecessary ocular risks, syringes should not be agitated before intravitreal injection. It is desirable that syringes be manufactured specifically for ophthalmic use.