title: Intravitreal injections using a novel conjunctival mould: a comparison with a conventional technique.
abstract: OBJECTIVE
  The aims were to compare a novel conjunctival mould used to assist the delivery of intravitreal drugs to a conventional technique with respect to patient, surgeon and cost benefit.
  
  
  METHODS
  A prospective review of 200 intravitreal injections was undertaken, 100 using a 'conventional' freehand technique (group 1) and 100 using a novel conjunctival mould (group 2). Intraoperative visual analogue scale (VAS) pain scores, patient preference, surgeon perception of the ease of insertion of the conjunctival mould were recorded as well as a cost comparison.
  
  
  RESULTS
  VAS pain score in the conventional group was 2.58 compared to 1.38 in the conjunctival mould group (p<0.01). The surgeon reported the insertion of the conjunctival mould as easy in 89 cases, moderate in 10 cases, and difficult in one case. The cost saving with a conjunctival mould pack compared to a conventional pack was £7.70; an annual saving of £19,250 for the trust.
  
  
  CONCLUSIONS
  The reduction in the VAS pain score with the conjunctival mould was statistically significant (p<0.01). The surgeons found that the device, which was easy to insert, offered excellent globe stability and a safe, reproducible entry site and angle of needle insertion.
authors.affiliation: Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK. g.ratnarajan@gmail.com
authors.forename: Gokulan
authors.initials: G
authors.lastname: Ratnarajan
authors.forename: Remin
authors.initials: R
authors.lastname: Nath
authors.forename: Shivashankar
authors.initials: S
authors.lastname: Appaswamy
authors.forename: Sarah-Lucie
authors.initials: SL
authors.lastname: Watson
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D003365:Costs and Cost Analysis; D016503:Drug Delivery Systems / Q000191:economics / Q000295:instrumentation*; D004867:Equipment Design; D058447:Eye Pain / Q000175:diagnosis; D006801:Humans; D058449:Intravitreal Injections / Q000191:economics / Q000295:instrumentation*; D008268:Macular Degeneration / Q000188:drug therapy*; D010147:Pain Measurement; D057240:Patient Preference; D010820:Physicians / Q000523:psychology; D011446:Prospective Studies; D000069579:Ranibizumab; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab