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. 2025 Sep;39(13):2489-2491.
doi: 10.1038/s41433-025-03899-8. Epub 2025 Jul 9.

Towards greener intravitreal injections: the Oxford Eye Hospital experience

Ariel Y Ong  1   2 , Thomas M W Buckley  1 , Johannes Birtel  1   3 , Samantha R de Silva  1   4 , Niamh Stone  1 , Peter Charbel Issa  5   6
Affiliations

Towards greener intravitreal injections: the Oxford Eye Hospital experience

Ariel Y Ong et al. Eye (Lond). 2025 Sep.
No abstract available

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Evolution of intravitreal injection standard operating protocol, uptake of proposed changes, and safety outcomes at the Oxford Eye Hospital from 2016–2024.
A Stepwise changes in the standard operating protocol for intravitreal injections at the Oxford Eye Hospital; B corresponding changes in the total number of intravitreal injections performed over time (line chart), together with the proportion of injections performed without a drape and speculum, or without a drape only (lid speculum alone) (bar chart); and C post-injection endophthalmitis rates per annum over the same period of time.
Fig. 2
Fig. 2. A minimalistic intravitreal injection technique that does not require the use of an intravitreal pack.
A aseptically withdrawing the drug through a filter needle (an additional step which is unnecessary for pre-filled syringes), B attaching the syringe to a needle, C marking the injection site with the needle cap in place of callipers, D manual lid retraction demonstrating the mark, E manual lid retraction with delivery of intravitreal injection, F post-delivery of intravitreal injection. Written informed consent for photography was obtained from the patient.
See this image and copyright information in PMC

References

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    1. Ong AY, Birtel J, Charbel Issa P. Greener intravitreal injections: a narrative review. Eye. 2024;38:2874–9. - PMC - PubMed
    1. Ong AY, Rigaudy A, Toufeeq S, Robins J, Shalchi Z, Bindra MS, et al. Intravitreal injections as a leading cause of acute postoperative endophthalmitis—a regional survey in England. Eye. 2023;37:163 - PMC - PubMed
    1. Birtel J, Hammer M, Feltgen N, Pauleikhoff L, Ong AY, Geerling G, et al. Intravitreal injections: improving sustainability by reducing clinical waste. Klin Monbl Augenheilkd. 2024;241:1156–62. - PubMed
    1. Fileta JB, Scott IU, Flynn HW. Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retin. 2014;45:143–9. - PubMed

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