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Which syringe type is better for intravitreal aflibercept injections?

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A recent study aimed to evaluate the incidence of sterile endophthalmitis after intravitreal aflibercept (Eylea; Regeneron) injection with 2 different types of syringes.

A total of 498 Intravitreal aflibercept injections were done, with 215 cases utilizing a 1-mL disposable syringe (Profi syringe, Shinchang Medical., Ltd. Korea) and 283 cases utilizing a 1-mL Becton Dickenson Luer-Lok syringe (BD, Franklin, NJ, USA).

Overall, 6 patients (2.791%) in the disposable syringe group and 1 patient (0.353%) in the BD Luer-Lok syringe groups were diagnosed with sterile endophthalmitis. The incidence of sterile endophthalmitis was significantly different between the groups (P = 0.046)

The authors concluded that BD Luer-Lok syringe is associated with a lower incidence of aflibercept-related sterile endophthalmitis than the conventional polypropylene syringe.

“Differences in immunogenicity associated with silicone oil lubricants within the syringes might be one of the potential reasons behind the difference in the incidence of the sterile endophthalmitis,” the authors wrote.

Kim M, Kim JT. Differences in the incidence of aflibercept-related sterile endophthalmitis according to types of disposable syringes used. Graefes Arch Clin Exp Ophthalmol. 2022;doi: 10.1007/s00417-021-05454-z. Epub ahead of print. PMID: 34977967.