American Journal of Ophthalmology
Volume 148, Issue 5 , Pages 725-732.e7, November 2009

SCORE Study Report 7: Incidence of Intravitreal Silicone Oil Droplets Associated With Staked-on vs Luer Cone Syringe Design

  • Ingrid U. Scott

      Affiliations

    • Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
    • ,
  • Neal L. Oden

      Affiliations

    • The EMMES Corp, Rockville, Maryland
    • ,
  • Paul C. VanVeldhuisen

      Affiliations

    • The EMMES Corp, Rockville, Maryland
    • Corresponding Author InformationInquiries to Paul C. VanVeldhuisen, The EMMES Corp, 401 N. Washington Street, Suite 700, Rockville, MD 20850
    • ,
  • Michael S. Ip

      Affiliations

    • University of Wisconsin, Madison, Wisconsin
    • ,
  • Barbara A. Blodi

      Affiliations

    • University of Wisconsin, Madison, Wisconsin
    • ,
  • Andrew N. Antoszyk

      Affiliations

    • Charlotte Eye Ear Nose and Throat Associates, Charlotte, North Carolina
    • ,
  • The SCORE Study Investigator Group

Accepted 1 June 2009. published online 11 August 2009.

Purpose

To evaluate the incidence of intravitreal silicone oil (SO) droplets associated with intravitreal injections using a staked-on vs luer cone syringe design in the SCORE (Standard Care vs COrticosteroid in REtinal Vein Occlusion) Study.

Design

Prospective, randomized, phase III clinical trial.

Methods

The incidence of intravitreal SO was compared among participants exposed to the staked-on syringe design, the luer cone syringe design, or both of the syringe designs in the SCORE Study, which evaluated intravitreal triamcinolone acetonide injection(s) for vision loss secondary to macular edema associated with central or branch retinal vein occlusion. Injections were given at baseline and 4-month intervals, based on treatment assignment and study-defined retreatment criteria. Because intravitreal SO was observed following injections in some participants, investigators were instructed, on September 22, 2006, to look for intravitreal SO at all study visits. On November 1, 2007, the luer cone syringe design replaced the staked-on syringe design.

Results

A total of 464 participants received a total of 1,205 injections between November 4, 2004 and February 28, 2009. Intravitreal SO was noted in 141 of 319 participants (44%) exposed only to staked-on syringes, 11 of 87 (13%) exposed to both syringe designs, and 0 of 58 exposed only to luer cone syringes (P < .0001). Among participants with first injections after September 22, 2006, intravitreal SO was noted in 65 of 114 (57%) injected only with staked-on syringes compared with 0 of 58 injected only with luer cone syringes. Differential follow-up is unlikely to explain these results.

Conclusion

In the SCORE Study, luer cone syringe design is associated with a lower frequency of intravitreal SO droplet occurrence compared with the staked-on syringe design, likely attributable to increased residual space in the needle hub with the luer cone design.

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 Supplemental Material available at AJO.com.

PII: S0002-9394(09)00404-8

doi:10.1016/j.ajo.2009.06.004

American Journal of Ophthalmology
Volume 148, Issue 5 , Pages 725-732.e7, November 2009

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