title: 25-GAUGE TROCAR CANNULA FOR ACUTE ENDOPHTHALMITIS-RELATED IN-OFFICE VITREOUS TAP AND INJECTION: Patient Comfort and Physician Ease of Use.
abstract: OBJECTIVE
  To assess comfort and procedural facility using a 25-gauge trocar cannula as a port to diagnose and treat acute endophthalmitis compared with a standard vitreous tap and injection technique.
  
  
  METHODS
  Eighteen consecutive patients with acute endophthalmitis were randomized into two treatment arms: 1) Standard vitreous tap and injection technique, and 2) A technique where a valved 25-gauge trocar cannula is inserted through the pars plana as done in sutureless vitrectomy surgery and subsequent vitreous sampling and injections are performed through the port. A standardized anesthetic protocol was used and subjects were masked to the technique performed. Primary outcomes measured were patient comfort using a Wong-Baker pain scale and standardized physician ease-of-use scoring scale. Secondary outcomes included vitreous sampling success rate and volume of vitreous sample.
  
  
  RESULTS
  No significant differences were found when comparing patient comfort (P = 0.340), physician ease-of-use scores (P = 0.796), vitreous sample volume (P = 0.149), successful vitreous taps (P = 0.620), and microbiologic yield (P = 1.000) between treatment arms. There were no adverse events.
  
  
  CONCLUSIONS
  The 25-gauge trocar technique provides a safe, well-tolerated, and equally effective alternative to the standard vitreous tap and injection technique for delivery of intravitreal antibiotics, and procuring of vitreous sample, requiring a single sharp penetration.
authors.affiliation: *Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; and †The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.
authors.forename: Sina
authors.initials: S
authors.lastname: Vahedi
authors.forename: Murtaza K
authors.initials: MK
authors.lastname: Adam
authors.forename: Michael
authors.initials: M
authors.lastname: Dollin
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Maguire
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001707:Biopsy, Needle / Q000295:instrumentation*; D057785:Catheters; D009877:Endophthalmitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D058449:Intravitreal Injections / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000070659:Patient Comfort; D010865:Pilot Projects; D011446:Prospective Studies; D014822:Vitreous Body / Q000601:surgery*