J Korean Ophthalmol Soc.  2020 Sep;61(9):1042-1047. 10.3341/jkos.2020.61.9.1042.

Ocular Pain According to Needle Diameter during Intravitreal Injection

  • 1Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea


To compare the ocular pain scores and injection times of patients during 30 and 40-gauge intravitreal injection procedures.
This study was performed prospectively in patients who had not previously received intravitreal injection. Patients were randomly divided into two groups and intravitreal injections of bevacizumab, ranibizumab, and aflibercept were performed using a 30-gauge needle (30G Group) or a 40-gauge needle (40G group). The injection time defined as the time between conjunctival touching of the needle and finishing the hemostasis after needle removal was measured in each patient. Immediately after the injection, patients were asked to rate their pain level during the injection using a visual analogue scale (0, no pain; 10, unbearable pain).
Sixty eyes of 60 patients were included in this study and 30 patients were assigned to each group. The mean injection times of the 30G and 40G groups were 42.00 ± 37.18 and 32.73 ± 14.58 seconds, respectively, with no significant difference (p = 0.212). The visual analogue scale, pain scores in the 30G and 40G groups were 3.50 ± 1.25 and 2.87 ± 1.01, respectively, with a significant difference (p = 0.035).
Intravitreal injection with a 40-gauge needle was less painful than that with a 30-gauge needle.


Intravitreal injection; Needle size; Pain measurement
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