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. 2023 Oct 14;7(6):498-503.
doi: 10.1177/24741264231200735. eCollection 2023 Nov-Dec.

Effect of Prefilled vs Vial-Drawn Syringes on Sustained Increases in Intraocular Pressure in Patients Treated With Aflibercept

Matthew W Russell  1   2 , Meghana Chalasani  3 , Neil Rana  4 , Justin C Muste  1   5 , Aleksandra V Rachitskaya  1   5 , Katherine E Talcott  1   5 , Rishi P Singh  1   5 , Sumit Sharma  1   5
Affiliations

Effect of Prefilled vs Vial-Drawn Syringes on Sustained Increases in Intraocular Pressure in Patients Treated With Aflibercept

Matthew W Russell et al. J Vitreoretin Dis. .

Abstract

Purpose: To evaluate the effect of syringe type on developing sustained intraocular pressure (IOP) increases. Methods: This retrospective cohort study included patients in a single academic center receiving antivascular endothelial growth factor (anti-VEGF) injections from 2012 to 2022 for various indications. Patients were grouped by anti-VEGF treatment of either vial-drawn or prefilled syringe delivery. Trends in IOP were recorded for 1 year after treatment began. Development of sustained IOP increase, ocular hypertension, and glaucoma was recorded. Sustained IOP increase was defined as ≥5 mm Hg above baseline for at least 4 weeks. Results: Of 257 total patients, 6 (2.3%) developed sustained IOP increases throughout the study's duration. No significant differences were noted with respect to prefilled versus vial-drawn syringe status on the development of sustained IOP increases or incident glaucoma (IOP: 1.8% vs 2.7%, respectively, P = .65; glaucoma: 0.0% vs 2.0%, respectively, P = .14). Patients treated with prefilled syringes were significantly less likely to develop ocular hypertension (2.8% vs 8.8%, P < .05). Conclusions: This study found that aflibercept intravitreal injection with prefilled syringes was not associated with a significant increase in IOP-related adverse effects when compared with those treated with vial-drawn syringes.

Keywords: intravitreal injection; prefilled syringe; sustained intraocular pressure increase.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Rachitskaya reports grant support from AGTC, Apellis, Genentech, NGM, and Novartis and consulting fees from Alcon, Apellis Genentech, Novartis, Regeneron, Zeiss. Dr. Talcott reports speaking fees from Genentech, grant support from Zeiss, and consulting fees from Genentech, Eyepoint, Apellis, and Regenxbio. Dr. Singh reports personal fees from Genentech/Roche, Alcon/Novartis, Zeiss, Bausch + Lomb, and Regeneron Pharmaceuticals and grant support from Apellis and Graybug. Dr. Sharma reports personal consulting fees from Alimera, Abbvie, Clearside, Eyepoint, Genentech/Roche, Bausch + Lomb, Regenxbio, and Regeneron and contracted research funding to his institution from Gilead, Abbvie, Genentech/Roche, Santen, and IONIS.

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