Comparison of patient’s comfort between two different techniques used for intravitreal injection Bevacizumab in terms of pain and conjunctival congestion.

Irfan Karamat, Sarmad Zahoor, Muhammad Shoaib, Uzma Malik, Sidra Latif, Muhammad Sultan Ul Moazzam, Saroosh Zahoor


OBJECTIVE: To compare level of comfort of patients in terms of pain and conjunctival congestion in intravitreal injection of Avastin (Bevacizumab) between old technique (OT) using speculum for lid retraction and modified technique (MT) with the use of bimanual assistance for lid retraction.

METHOD: Prospective analytical study. Fifty participants were enrolled in the study. A questionnaire for subjective assessment of patients’ comfort in terms of pain and objective assessment of conjunctival congestion was filled according to a predefined congestion scale immediately after intravitreal injections. Patients were followed up for 4 weeks.

RESULTS: Fifty patients were included in this study who were given intravitreal injection Avastin using speculum (OT) and bimanual assistance (MT), 25 with each technique. Our study showed that patients’ comfort was much more for modified technique than old technique in terms of pain and congestion. Average pain and congestion score in MT was 2.88±1.16 and 0.36±0.49 respectively. In OT, average pain and congestion score was 4.00±1.91 and 1.60±0.64 respectively. Using paired sample t-test, p-value<0.001 for both pain and congestion, was statistically significant.

CONCLUSION: Patients who underwent MT experienced lesser pain and congestion in comparison with those who were injected using OT. Hence, ease and comfort of patient in terms of pain and congestion was much more for MT than OT and MT proved to be a preferable technique in view of patient’s comfort.

Keywords: Intravitreal injection, Bevacizumab, pain, conjunctival congestion.


Intravitreal injection . Bevacizumab . Pain. Conjunctival congestion.

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