title: Prefilled syringes for intravitreal injection reduce preparation time.
abstract: BACKGROUND
  The demand for intravitreal therapy has increased dramatically with the introduction of vascular endo-thelial growth factor inhibitors. Improved utilisation of existing resources is crucial to meeting the increased future demand. We investigated time spent preparing intravitreal injection treatment using either prefilled syringes or vials in routine clinical practice.
  
  
  METHODS
  We video-recorded preparations of intravitreal injections (n = 172) for each preparation type (ranibizumab prefilled syringe (n = 56), ranibizumab vial (n = 56) and aflibercept vial (n = 60)) in a multi-centre time and motion study. The preparation times for each step were extracted from videos and the three preparation types were compared.
  
  
  RESULTS
  Prefilled syringes eliminated several steps in the preparation process. Total preparation time was 40.3-45.1 sec. using vials, and the use of prefilled syringes saved 25.5 sec. (95% confidence interval (CI): 23.3-27.6 sec., p < 0.0001). The preparation time when aflibercept vials were used was 3.7 sec. (95% CI: 1.45-5.96 sec., p = 0.0014) longer than when ranibizumab vials were used.
  
  
  CONCLUSIONS
  Prefilled syringes for intravitreal injections reduce preparation time by eliminating preparation steps that both entail a risk of contamination and are subject to variation. The amount of time saved may enable increased utilisation of existing resources and outsourcing to non-ophthalmologists.
  
  
  BACKGROUND
  This study was supported by a grant from Novartis. The funders had no influence on the design of the study, analysis of the data, preparation of the manuscript or the decision to publish.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: ysubhi@gmail.com.
authors.forename: Yousif
authors.initials: Y
authors.lastname: Subhi
authors.forename: Birgit
authors.initials: B
authors.lastname: Kjer
authors.forename: Inger Christine
authors.initials: IC
authors.lastname: Munch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy; D008297:Male; D009339:Needles; D000069579:Ranibizumab / Q000008:administration & dosage*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D013594:Syringes; D013996:Time and Motion Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014741:Video Recording
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab