ArticleOphthalmology and therapy2024
Effect of Needle Gauge Size on Pain During Intravitreal Anti-VEGF Injection: A Systematic Review and Network Meta-Analysis.
Article in Ophthalmology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- A randomized controlled single-blinded study comparing a 30-gauge needle to a 34-gauge needle for intravitreal injections.International ophthalmology · 2026Trial
- Anticipated and Actual Pain Intensity in Patients Receiving Intravitreal Injections: A Cross Sectional Study.Nursing open · 2026Article
- Effectiveness of Ultrathin 40-Gauge Needles for Intravitreal Injections.Korean journal of ophthalmology : KJO · 2026Article
- Evaluating the effectiveness of different topical anesthetic methods in reducing pain during intravitreal injections: a systematic review and meta-analysis.International journal of retina and vitreous · 2026Review
- Characterizing and assessing vision-related quality of life among patients discontinued treatment for neovascular age-related macular degeneration.Acta ophthalmologica · 2026Article
- Quadrant-Specific Pain in Intravitreal Injection: A Systematic Review and Meta-analysis.Ophthalmology and therapy · 2026Review
- Perception of pain during intravitreal injections: a clinical trial on the effect of entry site distance from the limbus on perceived pain.International journal of retina and vitreous · 2025Article
- Investigating the feasibility of selective anti-VEGF delivery to the retina using a microinvasive approach.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Article
- The relationship between pain intensity and anxiety, injection speed, and intraocular pressure changes during intravitreal anti-vascular endothelial growth factor injection: the observational pilot study.BMC ophthalmology · 2025Observational
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionConcerns related to pain from intravitreal injections are one of the key factors mentioned by patients when asked about therapy. In this systematic review and network meta-analysis, we evaluate the literature of comparative clinical trials on the relationship between needle gauge size and pain experience during intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy.
methodsWe searched 12 literature databases on 14 October 2023 for comparative studies of gauge sizes for intravitreal anti-VEGF injections. The primary outcome of interest was the reported pain experience immediately after the injection. All outcomes of pain were transformed into standardized effect sizes using Cohen's d. Using a network meta-analysis approach, we were able to compare all gauge sizes and rank them according to the reported pain experience.
resultsWe identified nine eligible studies with data on a total of 998 patients and 1004 eyes. Needle sizes studied were 26-gauge, 27-gauge, 29-gauge, 30-gauge, 32-gauge, 33-gauge, and 34-gauge. A complete network was present, which allowed for a network meta-analysis. We used the thickest (26-gauge) needle as the reference group and observed a clear trend of lower pain experience with thinner gauge sizes (d: -0.4, d: -2.7, d: -3.8, d: -4.8, d: -4.5, and d: -5.3; respectively, for 27-gauge, 29-gauge, 30-gauge, 32-gauge, 33-gauge, and 34-gauge).
conclusionA gauge size of 30 or thinner may minimize patient discomfort related to intravitreal anti-VEGF therapy.
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