Silicone Oil From Syringes —a Potentially Overlooked Issue for Intravitreal Injections—Reply

In Reply We would like to thank Melo et al for their interest in our recent publication entitled “Multiple Small Floaters Associated with Silicone Oil Droplets Following Intravitreal Pegcetacoplan Injection.” We share their concerns regarding the occurrence of symptomatic silicone oil droplets (SODs) following intravitreal injections (IVIs) of various ocular medications. In our report, we h ypothesized that repeated up and down movements of the syringe plunger intended to eliminate gas bubbles, combined with pegcetacoplan’s high viscosity, contributed to the occurrence of intravitreal SODs. In a previous report, Melo and colleagues failed to show release of silicone oil with similar plunger movements. However, this study used distilled water, which has a much lower viscosity than pegcetacoplan. Higher drug viscosity, extended plunger excursions, and greater applied force could potentially induce fluid dynamics comparable with those generated by maneuvers, such as flicking or ta pping the syringe, and possibly induce release of SODs in a similar manner.

Source: JAMA Ophthalmology - February 1, 2024 Category: Opthalmology Source Type: research