Intravitreal Injection Assistive Devices
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Intravitreal injections are among some of the most common procedures in ophthalmology. Among the indications include diabetic retinopathy, neovascular age-related macular degeneration, retinal vein occlusion with macular edema, and choroidal neovascularization from various etiologies.
In response to an increasing demand, some physicians have begun using intravitreal injection assistive devices to help deliver faster, safe, and accurate injections.
Contents
- 1 InVitria Injection Assistant (FCI Ophthalmics, Pembroke, MA)
- 2 Rapid Access Vitreal Injection (RAVI) Guide (Katalyst Surgical, Chesterfield, MO)
- 3 Doi-Umeatsu Intravitreal Injection Guide (Duckworth & Kent Ltd., England)
- 4 Malosa Intravitreal Injection Guide (Beaver-Visitec International, Waltham, MA)
- 5 Automated Injection Guide
- 6 Additional Resources
- 7 References
InVitria Injection Assistant (FCI Ophthalmics, Pembroke, MA)

Available Studies
A study by Ratnarajan et al used the InVitria in a series of injections without the use of a lid speculum, caliper and surgical drapes. They reported an improvement in pain reduction, globe stability, needle entry reproducibility and cost-effectivity compared with the conventional technique. [2] This device has also been shown to aid in the successful training of ophthalmic nurses in delivering intravitreal injections in the United Kingdom.[3] Baneke et al, however, advises against its use in post-trabeculectomy patients as its mould-like structure poses a risk for bleb-related complications.[4]
Rapid Access Vitreal Injection (RAVI) Guide (Katalyst Surgical, Chesterfield, MO)

Available Studies
The device has been shown to have similar pain scores with that of the traditional technique while successfully separating the eyelids and guiding injection of the needle.[6]
Doi-Umeatsu Intravitreal Injection Guide (Duckworth & Kent Ltd., England)

Available Studies
A study by Watanabe et al has demonstrated that the use of the guide in intravitreal injections is safe, even for physicians with limited experience.[8]
Malosa Intravitreal Injection Guide (Beaver-Visitec International, Waltham, MA)

Available Studies
Published studies have reported good patient feedback and minimal reduction in intraoperative pain in comparison with the traditional technique using a lid speculum.[10][11]
Automated Injection Guide
An automated assistive system for intravitreal injection has been proposed and was demonstrated to be effective in delivering precise injections in porcine eyes.[12] No known human studies have been reported.
Additional Resources
- Video: Invitria - Intravitreal Injection Device by FCI. https://www.youtube.com/watch?v=w14uh44RSRk
- Video: Doi-Umeatsu Intravitreal Injection Guide. https://www.youtube.com/watch?v=U-1hYkSIynU&t=128s
- Video: Malosa Intravitreal Injection Guide. https://www.youtube.com/watch?v=USc80RIhOkA
References
- ↑ Ratnarajan G, Nath R, Appaswamy S, Watson SL. Intravitreal injections using a novel conjunctival mould: a comparison with a conventional technique. Br J Ophthalmol. 2013;97(4):395–397.
- ↑ Ratnarajan G, Nath R, Appaswamy S, Watson SL. Intravitreal injections using a novel conjunctival mould: a comparison with a conventional technique. Br J Ophthalmol. 2013;97(4):395–397.
- ↑ Michelotti MM, Abugreen S, Kelly SP, et al. Transformational change: nurses substituting for ophthalmologists for intravitreal injections - a quality-improvement report. Clin Ophthalmol. 2014;8:755–761. Published 2014 Apr 15.
- ↑ Baneke AJ, Vakros G, Sharma V, Wong SC. BLEB-RELATED ENDOPHTHALMITIS AFTER USE OF THE INVITRIA INJECTION GUIDE. Retin Cases Brief Rep. 2020;14(1):33–34.
- ↑ Han DP, McKenney KC, Kim JE, Weinberg DV, Musch DC, Singh RS. CLINICAL EVALUATION OF THE RAPID ACCESS VITREAL INJECTION GUIDE: A Handheld Instrument for Assisting Intravitreal Injections. Retina. 2017;37(4):778–781.
- ↑ Han DP, McKenney KC, Kim JE, Weinberg DV, Musch DC, Singh RS. CLINICAL EVALUATION OF THE RAPID ACCESS VITREAL INJECTION GUIDE: A Handheld Instrument for Assisting Intravitreal Injections. Retina. 2017;37(4):778–781.
- ↑ Watanabe K, Masafumi U, Mohamed YH, Watanabe T, Doi Y, Azusa F, Kitaoka T. Safety of Intravitreal Injection Guide. J Vitreoretin Dis. 2017;2(1):26–31.
- ↑ Watanabe K, Masafumi U, Mohamed YH, Watanabe T, Doi Y, Azusa F, Kitaoka T. Safety of Intravitreal Injection Guide. J Vitreoretin Dis. 2017;2(1):26–31.
- ↑ Waqar S, Ayaz A, Karamat I, et al. A novel device for rapid, safe and precise delivery of intravitreal injections. BMJ Innov Epub ahead of print: [22 March 2020]. doi:10.1136/ bmjinnov-2018-000337
- ↑ Waqar S. Comment on: Optimisation of intravitreal injection technique using a Barraquer speculum with solid flat blade and finger stabilisation. Eye (Lond). 2019;33(3):512.
- ↑ Waqar S, Ayaz A, Karamat I, et al. A novel device for rapid, safe and precise delivery of intravitreal injections. BMJ Innov Epub ahead of print: [22 March 2020]. doi:10.1136/ bmjinnov-2018-000337
- ↑ Ullrich F, Michels S, Lehmann D, Pieters RS, Becker M, Nelson BJ. Assistive Device for Efficient Intravitreal Injections. Ophthalmic Surg Lasers Imaging Retina. 2016;47(8):752–762.