title: SCORE Study Report 7: incidence of intravitreal silicone oil droplets associated with staked-on vs luer cone syringe design.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
authors.forename: Ingrid U
authors.initials: IU
authors.lastname: Scott
authors.forename: Neal L
authors.initials: NL
authors.lastname: Oden
authors.forename: Paul C
authors.initials: PC
authors.lastname: VanVeldhuisen
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ip
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Blodi
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Antoszyk
mesh_terms: D001766:Blindness / Q000534:rehabilitation; D004867:Equipment Design; D005129:Eye Foreign Bodies / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007267:Injections / Q000009:adverse effects; D008269:Macular Edema / Q000188:drug therapy*; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D012827:Silicone Oils; D013594:Syringes / Q000009:adverse effects*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014822:Vitreous Body / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D012827:Silicone Oils; D014222:Triamcinolone Acetonide
references.citation: Retina. 2006 Jul-Aug;26(6):701-3
references.pmid: 16829818
references.citation: Jpn J Ophthalmol. 1991;35(3):282-91
references.pmid: 1770668
references.citation: Retina. 2008 Jul-Aug;28(7):996-1001
references.pmid: 18698303
references.citation: Ophthalmology. 2009 Sep;116(9):1770-1777.e1
references.pmid: 19619896