title: Tunneled scleral incision to prevent vitreal reflux after intravitreal injection.
abstract: OBJECTIVE
  To investigate the efficacy of tunneled scleral incision compared with standard straight scleral incision to prevent vitreal reflux after intravitreal (IVT) injection.
  
  
  METHODS
  Prospective comparative controlled nonrandomized clinical study.
  
  
  METHODS
  Eighty-eight eyes undergoing IVT-injection were allocated into four groups to compare the vitreal reflux after injection of 0.1 ml of triamcinolone acetonide (TA) and Avastin using a tunneled vs straight injection technique. The amount of intraoperative drug reflux was estimated by measuring the width of the subconjunctival bleb.
  
  
  RESULTS
  The mean measured reflux of volume was statistically less with the tunneled scleral incision (1.13 mm standard deviation [SD] +/- 1.16 for TA; 1.13 mm SD +/- 1.39 for Avastin) than in eyes undergoing the straight scleral injection (3.00 mm SD +/- 1.77 for TA; 3.18 mm SD +/- 1.68 for Avastin) for both Avastin and TA IVT-injections groups (P < .001).
  
  
  CONCLUSIONS
  The tunneled scleral incision promotes statistically significant less vitreal reflux for IVT drug injection.
authors.affiliation: Retina Department, Hospital Regional São Jose, Centro Oftalmológico, Florianópolis, Brazil. edubrodriguess@yahoo.com.br
authors.forename: Eduardo B
authors.initials: EB
authors.lastname: Rodrigues
authors.forename: Carsten H
authors.initials: CH
authors.lastname: Meyer
authors.forename: Astor
authors.initials: A
authors.lastname: Grumann
authors.forename: Helio
authors.initials: H
authors.lastname: Shiroma
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Aguni
authors.forename: Michel E
authors.initials: ME
authors.lastname: Farah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012164:Retinal Diseases / Q000188:drug therapy; D012590:Sclera / Q000473:pathology / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014822:Vitreous Body / Q000187:drug effects*; D014945:Wound Healing
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide