title: Assessment of the risk of needlestick injuries associated with intravitreal injections.
abstract: OBJECTIVE
  To assess the overall risk of needlestick injuries (NSIs) associated with intravitreal injection, and more specifically related to the practice of compounding pharmacies of applying informational adhesive stickers to repackaged bevacizumab injection syringes.
  
  
  METHODS
  This cross-sectional study involved an online survey of retina specialists in the United States.
  
  
  RESULTS
  Of the 717 invited retina specialists, 158 (22%) responded to the online survey. The respondents reported using 1 pair of gloves (51%), no gloves (46%), or 2 pairs of gloves (3%) during intravitreal injection. Repackaged bevacizumab syringes distributed by compounding pharmacy were used by 89% of the respondents, and 63% reported that the adhesive sticker was applied directly to the syringe. Unintentional adhesion between the sticker and hand or glove was experienced by 9% of respondents. At least 1 NSI during intravitreal injection was experienced by 8% of respondents, and sticker-related injury was reported by 3%. The sticker was perceived to increase risk for NSI by 33% of respondents.
  
  
  CONCLUSIONS
  This survey showed that 8% of the responding physicians surveyed have experienced at least one NSI during intravitreal injections, of which approximately one third was attributed to the adhesive sticker. Direct application of misfitting stickers to repackaged syringes by compounding pharmacies may be a practice that can aggravate the risk of NSI.
authors: Retina Division, Jules Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors: Sanket U
authors: SU
authors: Shah
authors: Michael J
authors: MJ
authors: Koenig
authors: Yann
authors: Y
authors: Dacquay
authors: Arash
authors: A
authors: Mozayan
authors: Jean-Pierre
authors: JP
authors: Hubschman
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D003430:Cross-Sectional Studies; D004339:Drug Compounding / Q000009:adverse effects; D004348:Drug Labeling; D006306:Health Surveys; D006801:Humans; D058449:Intravitreal Injections / Q000009:adverse effects*; D016602:Needlestick Injuries / Q000209:etiology*; D056687:Off-Label Use; D009885:Ophthalmology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013594:Syringes / Q000009:adverse effects*; D014481:United States; 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; D000068258:Bevacizumab