Efficacy of the Newly Invented Eyelid Clamper in Ultra-Widefield Fundus Imaging

Background: Ultra-widefield fundus imaging is widely used for obtaining wide angle images of the retina in one single image. Although it has a potential to obtain a wide area of retinal photographs, images are often obstructed by eyelashes or eye lids. In this study, we used a newly invented eyelid clamper, which can keep an eye open without touching conjunctiva or lid margin, to assess the efficacy in clinical use by comparing with conventional tape fixation. Methods: Ultra-widefield fundus images were captured with an ultra-widefield imaging system in 19 patients who visited to the outpatient clinic of Department of Ophthalmology, Keio University Hospital with the eyelid clamper or a conventional tape fixation. The area of imaged retinas was outlined and quantified with pixels. After obtaining images, patients answered a questionnaire. Results: The average number of pixels in total areas with the eyelid clamper or with tape fixation were 4.31 ± 0.35 and 4.32 ± 0.34 mega pixels, respectively, showing no significant difference between the groups (p = 0.889). The average face pain scale of the eyelid clamper was 1.13 on a scale of 0 to 5. The number of patients who did not feel any pain was nine (47.4%). Conclusions: The eyelid clamper can be applied in clinical setting and can better support obtaining sufficiently wide fundus images compared to a conventional tape fixation.

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Medic Interaction Modes and Hospitalized Children Health

10.31124/advance.8337683 ◽

2019 ◽

Author(s):

Naveed Shibli ◽

Miss Shehrish Farooq

Keyword(s):

Experimental Study ◽

Health Outcomes ◽

Block Design ◽

Pain Scale ◽

Hospitalized Children ◽

Face Pain ◽

Children Health ◽

Face Pain Scale

In the present experimental study different interaction ‘modes’ those took place between a psychologist and a child were tested for the role of these towards health recovery of the child? Following were the interaction modes, a) presenting a flower with smile plus inquiring about health, b) offering a blessing plus inquiring about health, c) making an indifferent presence plus inquiring about health with flat tone, d) inquiring about health with providing precautions about prognosis. It was assumed that all modes would differently influence health outcomes? 100 hospitalized children located in child wards of different hospitals with randomized pre-post block design interacted. One each from four interaction modes was used for a group of 25 participants each. Actual ward discharge was compared with anticipatory estimated by each ward in-charge to calculate effect of mode on outcome. Face Pain Scale, The Children Happiness Scale and a Demographic Sheet were also used. Results reflected ‘modes’ relationship with outcomes. More studies would clarify further.

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Near-infrared fundus imaging system with light illumination from an electronic contact lens

Applied Physics Express ◽

10.35848/1882-0786/ac4675 ◽

2022 ◽

Vol 15 (2) ◽

pp. 027001

Author(s):

Yang Cui ◽

Taiki Takamatsu ◽

Koichi Shimizu ◽

Takeo Miyake

Keyword(s):

Contact Lens ◽

Near Infrared ◽

Imaging System ◽

Low Cost ◽

Light Illumination ◽

Fundus Images ◽

Fundus Imaging ◽

Point Spread ◽

Spread Function ◽

Dependent Point

Abstract As for the diagnosis and treatment of eye diseases, an ideal fundus imaging system is expected to be portability, low cost, and high resolution. Here, we demonstrate a non-mydriatic near-infrared fundus imaging system with light illumination from an electronic contact lens (E-lens). The E-lens can illuminate the retinal and choroidal structures for capturing the fundus images when voltage is applied wirelessly to the lens. And we also reconstruct the images with a depth-dependent point-spread function to suppress the scattering effect that eventually visualizes the clear fundus images.

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Reguliuojamos skrandžio apjuosimo juostos: lyginamųjų studijų apžvalga

Lietuvos chirurgija ◽

10.15388/lietchirur.2011.1.2090 ◽

2011 ◽

Vol 9 (1-2) ◽

pp. 0-0

Author(s):

Tomas Abalikšta ◽

Gintautas Brimas ◽

Kęstutis Strupas

Keyword(s):

Weight Loss ◽

Comparative Studies ◽

University Hospital ◽

Cochrane Library ◽

Band Slippage ◽

Lap Band ◽

Number Of Patients ◽

Significant Difference ◽

Gastric Bands

Tomas Abalikšta, Gintautas Brimas, Kęstutis Strupas Vilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 VilniusVilniaus universiteto ligoninės Santariškių klinikų Pilvo chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl. paštas: [email protected] Darbo tikslas: Remiantis literatūros duomenimis palyginti skirtingas skrandžio apjuosimo reguliuojamas juostas, naudojamas chirurginiam nutukimo gydymui. Tyriamoji medžiaga ir metodai: Publikacijų paieška atlikta elektroninėse MEDLINE, Current Contents ir Cochrane Library duomenų bazėse. Apžvelgtos visos skrandį apjuosiančių reguliuojamų juostų lyginamųjų studijų publikacijos, paskelbtos iki 2010 m. sausio 1 d. Rezultatai: Atlikus literatūros šaltinių paiešką rasta 10 publikacijų, lyginančių skirtingas skrandį apjuosiančias reguliuojamas juostas. Išsamiai atlikta viena studija: perspektyvi, atsitiktinių imčių, jos tiriamųjų skaičius didelis ir stebėjimo laikotarpis ilgas, įvertinti visi gydymo rezultatai. Statistiškai reikšmingo skirtumo tarp SAGB ir LAP-BAND juostų šioje studijoje nerasta. Kitos lyginamosios juostų studijos turi trūkumų: keturios buvo ne atsitiktinių imčių (dvi iš jų retrospektyvios), trijose tiriamųjų imtis maža, visų stebėjimo laikas trumpas. Vienoje iš šių studijų nustatytas kūno masės kritimo skirtumas tarp grupių: LAP-BAND grupėje pradinė viršnorminė kūno masė sumažėjo 41,7 %, Heliogast – 28,3 %. Mechaninių juostų komplikacijų dažnis skyrėsi vienoje studijoje: LAP-BAND – 7 %, SAGB – 1 %. Skirtumas tarp „mažo skrandžio“ išsiplėtimo arba juostos nuslinkimo dažnio rastas trijose studijose (MiniMizer Extra – 0 % ir LAP-BAND – 10,8 %; SAGB – 2,4 % ir LAP-BAND – 27,6 %; SAGB – 2 % ir LAP-BAND – 23 %). Skirtumo tarp gretutinių ligų ir gyvenimo kokybės pokyčio, hospitalizacijos trukmės, juostos reguliavimų skaičiaus/dažnio, juostos penetracijos/migracijos į skrandį bei infekcinių komplikacijų dažnio nerasta. Išvados: Tik viena studija atlikta laikantis šiuolaikinių įrodymais pagrįstos medicinos keliamų reikalavimų, skirtumo tarp lygintų juostų nerasta. Reikalingos perspektyvios, atsitiktinių imčių ilgalaikės (>5 metų) lyginamosios studijos, vertinančios juostų konstrukcijos ar formos skirtumų įtaką gydymo efektyvumui ar komplikacijoms. Reikšminiai žodžiai: nutukimas, bariatrinė chirurgija, skrandžio apjuosimo reguliuojama juosta operacija. Adjustable gastric bands: review of comparative studies Tomas Abalikšta, Gintautas Brimas, Kęstutis Strupas Vilnius University Medical Faculty, M. K. Čiurlionio Str. 21, LT-03101 Vilnius, LithuaniaVilnius University Hospital Santariškių Klinikos Centre of Abdominal Surgery,Santariškių Str. 2, LT-08661 Vilnius, LithuaniaEl. paštas: [email protected] Objective: The objective of this review is to compare different adjustable gastric bands according to the data of comparative studies. Materials and Methods: A search of articles published in any language before January 2010 was carried out through the MEDLINE, Current Contents and Cochrane Library electronic databases. All articles about comparative studies of different adjustable gastric bands were eligible for review. All possible data were extracted from accepted studies and reviewed. Results: Ten comparative studies of different adjustable gastric bands were accepted. Only one comparative study of the bands was accomplished properly. It was a prospective randomised study type with a large number of patients and a long follow-up period with all possible results evaluated. No statistically significant difference between SAGB and LAP-BAND gastric bands was found in this study. The other band studies had shortcomings: four studies were non-randomised (two of them retrospective), a small number of patients in three studies, and a too short follow-up period in all studies. The difference in weight loss was stated in one of these studies: 41.7% of initial excess weight loss in the LAP-BAND group and 28.3% in the Heliogast group. Band leakage frequency was different in one study: LAP-BAND – 7%, SAGB – 1%. A difference between pouch dilatation or band slippage frequency was found in three studies (MiniMizer Extra – 0% and LAP-BAND – 10.8%; SAGB – 2.4% and LAP-BAND – 27.6%; SAGB – 2% and LAP-BAND – 23%). There was no difference between the resolution of comorbidities, improvement of the quality of life, hospital stay, band adjustment frequency, band migration or band infection rate. Conclusion: Only one accepted study was accomplished properly. There was no difference between compared adjustable gastric bands in this study. Prospective randomised long-term (more than 5 years) comparative studies are needed for a proper evaluation of band construction or shape influence on weight loss and complications. Keywords: obesity, bariatric surgery, adjustable gastric banding.

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P-681 Will the hCG trigger dose used for final oocyte maturation in IVF impact endogenous progesterone during the luteal phase? - A randomized controlled trial

Human Reproduction ◽

10.1093/humrep/deab125.052 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

L Svenstrup ◽

J Fedder ◽

S Möller ◽

D Pedersen ◽

K Erb ◽

...

Keyword(s):

Oocyte Maturation ◽

Luteal Phase ◽

Controlled Trial ◽

University Hospital ◽

Final Oocyte Maturation ◽

Randomized Controlled ◽

Number Of Patients ◽

Significant Difference ◽

Hcg Trigger ◽

Group 1

Abstract Study question Is there an association between the hCG dose used for ovulation trigger and the endogenous progesterone production during the luteal phase? Summary answer Increased hCG dosing significantly increased the endogenous progesterone level during the luteal phase. What is known already During the luteal phase of an IVF treatment, the endogenous progesterone (P4) production is negatively impacted due to reduced circulating endogenous LH, caused by negative feed-back of elevated steroids; thus, luteal phase support (LPS) with exogenous P4 remains mandatory in IVF. Apart from inducing final oocyte maturation, the gold standard HCG trigger also functions as an early LPS, boosting P4 production by the corpora lutea (CL). P4 plays a pivotal role for embryo implantation and pregnancy, and an optimal P4 level around peri-implantation seems to be essential for the reproductive outcomes of fresh and frozen/thaw embryo transfer cycles. Study design, size, duration A randomized controlled 4-arm study, including a total of 127 IVF patients, enrolled from January 2015 until September 2019 at the Fertility Clinic, Odense University Hospital, Denmark. Participants/materials, setting, methods IVF patients with ≤ 11 follicles ≥ 12 mm were randomized to four groups. Groups 1-3 were triggered with: 5.000 IU, 6.500 IU or 10.000 IU, hCG, respectively, receiving a LPS consisting of 17-α-hydroxy-progesterone (17α OH P4) to distinguish the endogenous P4 from the exogenous supplementation. Group 4 (control) was randomized to a 6.500 IU hCG trigger and standard LPS. A total of eight blood samples were drawn during the early luteal phase. Main results and the role of chance A total of 94 patients completed the study: 21, 22, 25 and 26 patients in each group, respectively. Baseline characteristics were similar, except for the endogenous LH level and cycle lengths. There were no significant differences between groups regarding ovarian stimulation, number of oocytes and embryos. The median number of follicles ≥ 12mm on the day of trigger was 8.5, resulting in 6.6 oocytes being retrieved. Significant differences in P4 levels were seen at OPU+8 (p < 0.001), OPU+10 (p < 0.001) and OPU+14 (p < 0.001), with positive correlations between P4 level and hCG dose. Groups compared individually showed significant difference in P4 between low and high trigger dose at OPU+4 group 1 and 3 (p = 0.037) and OPU+8 group 1 and 3 (p = 0.007) and between all the three groups around implantation at OPU+6 group 1 and 2 (p = 0.011), group 2 and 3 (p = 0.042) and group 1 and 3 (p < 0.001). Higher P4 levels around implantation were related to follicle count and to pregnancy. After logistic regression analyses there were still significant individual differences between the groups. Limitations, reasons for caution Although patients were randomized and strict inclusion and exclusion criteria were used, the RCT was un-blinded, including a relatively small number of patients. Moreover, for dosing purposes urinary hCG as well as recombinant hCG was used and pharmacokinetics differ. Finally, the P4 level could be influenced by circadian fluctuations. Wider implications of the findings This is the first study to explore dose-responses in circulating P4 after hCG trigger in IVF patients. Increasing the hCG trigger dose increased the endogenous P4 around peri-implantation. Personalizing the hCG trigger dose could be a key point to secure the most optimal P4 mid-luteal phase P4 level. Trial registration number Eudract 2013-003304-39

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Association between Neuroleptics and Venous Thromboembolism: A Case-Control Study.

Blood ◽

10.1182/blood.v104.11.2601.2601 ◽

2004 ◽

Vol 104 (11) ◽

pp. 2601-2601

Author(s):

Karine Lacut ◽

Gregoire Le Gal ◽

Emmanuel Oger ◽

Dominique Mottier

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Antipsychotic Drugs ◽

Case Control Study ◽

Case Control ◽

University Hospital ◽

Number Of Patients ◽

Increased Risk ◽

Significant Difference ◽

Control Study

Abstract Background: Preliminary reports suggest that use of antipsychotic drugs is associated with an increased risk of venous thromboembolism (VTE), but others did not confirm these results. Objective: To evaluate the relationship between antipsychotic drugs and VTE. Design: Case-control study (EDITH) designed to investigate genetic and environmental risk factors of VTE. Setting: Brest University Hospital. Participants: 857 patients consecutively hospitalized for a documented venous thromboembolic event were included between May 2000 and May 2004. Controls were matched on age, sex and the main risk factors of venous thromboembolism (cancer, surgery, pregnancy…). Results: The mean age of patients was 67.7 year. No significant difference was found between cases and controls concerning the main characteristics, except for smocking and body mass index. Among cases, 89 (10.4%) were current users of neuroleptics compared to 35 (4.8%) among controls. Current use of neuroleptics was associated with a significant increased risk of venous thromboembolism (OR = 2.32, 95% CI: 1.55–3.48). Excluding neuroleptics used for non psychiatric disorders, and after adjustment on the main confounding factors, this association remained significant (OR = 3.48, 95% CI: 2.00–6.04). No difference was found between the different chemical categories of neuroleptics, but the number of patients in some groups had limited statistical power to demonstrate significant differences. Biological mechanisms of action have been proposed to explain this relation. Analyses are ongoing for anti-phospholipid antibodies and homocysteine. Conclusion: In this case-control study of hospitalized patients, neuroleptics use was associated with a significant increased risk of venous thromboembolism. These results are concordant with previous reports. Nevertheless, further investigations are needed to explain wich mechanisms may be involved in such association and before use of neuroleptics can be definitely considered as risk factor for venous thromboembolism.

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Efficacy of Yttrium-90 Zevalin Outside of Clinical Trials: Preliminary Results of a Retrospective Bi-Center Study

Blood ◽

10.1182/blood.v112.11.5015.5015 ◽

2008 ◽

Vol 112 (11) ◽

pp. 5015-5015

Author(s):

Francesco Cicone ◽

Francesco Scopinaro ◽

Sebastien Baechler ◽

Nicolas Ketterer ◽

Franz Buchegger ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Setting ◽

Patient Population ◽

Statistical Significance ◽

University Hospital ◽

Low Grade ◽

Number Of Patients ◽

Significant Difference ◽

Routine Clinical Setting

Abstract Background and Aim: Due to limited data regarding the efficacy of Radioimmunotherapy with 90Y-Zevalin (RIT-Z) outside of controlled clinical trials, we carried out a biinstitutional, international retrospective study to assess the efficacy of RIT-Z in a routine clinical setting. The relationship between the number of previous therapies and outcomes as well as the response to the last therapy was assessed. Possible differences in outcomes for patients treated in the two different centers were also analyzed. Materials and Methods: Forty-three consecutive patients treated at the University Hospital of Lausanne (CHUV, Switzerland) and at S. Andrea University Hospital of Rome (Italy) were evaluated, none of which had been previously included in clinical trials. Only 31 patients entered the final analysis: patients lost at follow up, undergoing autologous transplantation (ASCT), or treated within the last 3 months were excluded. Efficacy of therapy was evaluated in terms of Overall Survival (OS), Progression Free Survival (PFS), and Time to Next Treatment (TTNT). Survival curves were obtained with the Kaplan- Meier method (statistical significance = p<0.05). Results: Characteristics of the patient population are listed in Table 1. Although 50% of the patients had aggressive histologies, patients treated at S. Andrea had slightly more favorable features than those treated at CHUV. Fourteen patients (45%) had received at least 4 previous treatments, and all had received Rituximab. Fourteen patients (45%) had not responded to the last therapy, while 6 (19%), all treated at S.Andrea, were considered disease-free at the time of RIT-Z, which was administered for consolidation. Median follow up time was 20 months (11.5 vs. 25 months for S.Andrea and CHUV, respectively). Median PFS and TTNT were similar. After achieving a partial response, 2 patients were referred to Rituximab maintenance after RIT-Z and remain progression-free. Median OS was still not attained. Although not statistically significant, a trend towards better outcomes for S. Andrea patients was found. In comparing patients with indolent and aggressive lymphoma, only PFS was found to be significantly different (median PFS: 10 vs. 5 months, p<0.05). In patients with <4 and ≥ 4 previous therapies, twenty month OS was 88% vs. 53.6% (p=0.02), respectively; median TTNT was 22 vs. 5 months (p=0.013), while differences in PFS did not attain statistical significance. The duration of response in non-responders to their last therapy was shorter than in responders: 20-month OS- 44% vs. 94% (p=0.0015), median PFS and TTNT- 3.5 vs. 15 months (p=0.0002) and 4 vs. 15 months (p=0.0001), respectively. Median PFS and TTNT after RIT-Z did not differ from those found after the last therapy. A significant difference in outcomes for heavily pretreated or refractory patients was found in those with low grade follicular lymphoma. Conclusions: Poorer outcomes were found in our patient population treated in a routine clinical setting compared to those enrolled in clinical trials. This may be related to greater heterogeneity of our study cohort which included more patients with unfavorable conditions (e.g. aggressive NHL, ≥4 treatment courses including rituximab in all, and ASCT in 25%). Our results suggest that the best benefit may be expected with RIT-Z either for consolidation or relatively earlier in the course of NHL treatment. Table 1. Total CHUV S. Andrea Population Analyzed (72%) Number of patients 43 23 20 31 Median Age 61 63 58,5 62 Aggressive Histology (FL grade 3 or DLBCL) 18 (41,8%) 8 (34,7%) 10 (50%) 11 (35,5%) Indolent Histology (FL grade 1 or 2) (%) 25 (58,2%) 15 (65,3%) 10 (50%) 20 (64,5%) Patients with ≥4 previous treatments 19 (44,2%) 12 (52,1%) 7 (35%) 14 (45,2%) Patients with previous ASCT 11 (25,6%) 6 (26%) 5 (25%) 8 (25%)

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The Effect Of Hyaluronic Acid To Pain Intensity Rated By Face Pain Scale-Revised On Knee Osteoarthritis Patients

Journal Widya Medika Junior ◽

10.33508/jwmj.v2i1.2336 ◽

2020 ◽

Vol 2 (1) ◽

pp. 58-64

Author(s):

Felicia Putri Hartono ◽

◽

Nunung Nugroho ◽

Endang Isbandiati ◽

◽

...

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Pain Intensity ◽

Pain Scale ◽

Face Pain ◽

Face Pain Scale

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PENGARUH SENAM YOGA TERHADAP NYERI HAID PADA REMAJA PUTRI KELAS X MAN 2 KOTA PROBOLINGGO (Di Madrasah Aliyah Negeri 2 Kota Probolinggo)

Sentani Nursing Journal ◽

10.52646/snj.v2i2.87 ◽

2021 ◽

Vol 2 (2) ◽

pp. 77-83

Author(s):

Endah Putri R ◽

Harnanik Nawangsari

Keyword(s):

Random Sampling ◽

Pain Scale ◽

Spearman Rank ◽

Face Pain ◽

Face Pain Scale ◽

R Value ◽

Sampling Variable

Masa remaja berhubungan dengan suatu fenomena fisik yang berhubungan dengan pubertas. Pubertas merupakan suatu bagian penting dari masa remaja yang lebih menekankan proses biologis yang mengarah pada kemampuan reproduksi. Pada saat ini perempuan akan mengalami ovulasi dan menstruasi yang terkadang juga disertai nyeri haid (dysmenorrhea). Berdasarkan Studi Pendahuluan yang dilakukan peneliti didapatkan hasil wawancara dari 15 siswi, terdapat 13 siswi yang mengalami dysmenorrhea. Penelitian ini bertujuan untuk mengetahui Pengaruh Senam Yoga terhadap Nyeri Haid pada Remaja Putri Kelas X MAN 2 Kota Probolinggo. Jenis penelitian ini adalah pra eksperimental dengan rancangan one group pretest posttest design. Populasi penelitian ini adalah seluruh siswi kelas X MAN 2 Kota Probolinggo yang berjumlah 172 siswi. Sampel penelitian ini sejumlah 35 siswi dengan tekhnik sampling Proportional Random Sampling. Variable independent adalah Senam Yoga dan variable dependent adalah Nyeri Haid. Instrumen penelitian menggunakan pengukuran skala nyeri Face Pain Scale – Revised (FPS-R). Pengolahan data menggunakan editing, coding, scoring, tabulating dengan analisa data spearman Rank. Hasil penelitian menunjukkan bahwa sebelum dilakukan senam yoga hampir setengah dari responden mengalami nyeri haid dengan skala 3 (lebih nyeri) dengan jumlah 16 responden (45,7%). Sedangkan setelah dilakukan senam yoga hampir setengah dari responden mengalami nyeri haid dengan skala 2 (sedikit nyeri) sebanyak 12 responden (34,3%). Uji statistik Spearman rank menunjukan bahwa r value = 0,000 < α (0,05) sehingga H1 diterima.Kesimpulan penelitian ini ada Pengaruh Senam Yoga terhadap Nyeri Haid pada Remaja Putri Kelas X MAN 2 Kota Probolinggo. Kata Kunci : Senam Yoga, Nyeri Haid, Siswi Kelas X

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Safety of Intravitreal Injection Guide

Journal of VitreoRetinal Diseases ◽

10.1177/2474126417728622 ◽

2017 ◽

Vol 2 (1) ◽

pp. 26-31

Author(s):

Kei Watanabe ◽

Uematsu Masafumi ◽

Yasser H. Mohamed ◽

Takehito Watanabe ◽

Yusuke Doi ◽

...

Keyword(s):

Intravitreal Injection ◽

University Hospital ◽

Vascular Endothelial ◽

Drug Usage ◽

Anti Vegf ◽

Systemic Complication ◽

Department Of Ophthalmology ◽

Significant Difference ◽

Period Data ◽

Endothelial Growth Factor

Purpose: To evaluate the safety of our developed intravitreal injection guide. Methods: Retrospective review of all case notes for consecutive patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections at the Department of Ophthalmology, Nagasaki University Hospital in Japan between January 2013 and December 2014. We included all patients who had at least 1 intravitreal anti-VEGF injection done within the study period. Data collected included demographics, indications of intravitreal anti-VEGF injections, type of injected drug, usage of intravitreal guide, experience of physicians, and any complication that occurred during or after the procedure. Results: The study included 256 patients (154 males and 102 females) who underwent 992 intravitreal anti-VEGF injections from January 2013 until December 2014. The mean age of the patients was 70.8 ± 11.3 years. Of total injections, 907 (91.44%) were done using the intravitreal guide, 60 (6.04%) were done without using the guide, and only 25 (2.52%) injections were not determined. Local complications include 1 (0.1%) case uveitis, 1 (0.1%) case retinal tear, and 1 (0.1%) case amaurosis fugax. There were no major complications as cataract, retinal detachment, and endophthamitis. No systemic complication was encountered. All complications occurred in the guide group without statistically significant difference in comparison to without guide group ( P = 1.0). All complications were related to experienced group without significant difference in comparison to limited experienced group ( P = .28). Conclusion: We conclude that the process of intravitreal injection with our developed intravitreal injection guide is safe and easy even for limited experienced physicians.

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