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The InVitria injection assistant


The InVitria Injection Assistant


With intravitreal injections now playing such a central role in many retina practices, clinicians and patients alike welcome any advances that simplify and streamline the procedure. A new product from FCI Ophthalmics called the InVitria injection assistant allows injections to occur at a fixed angle, position and depth each time.

"The idea was to have a disposable device which could provide a predictable, easy, safe, comfortable, cheap and fast procedure," says the device's inventor, Arnaldo Gonçalves, MD, of the Netherlands. "The procedure of the traditional treatment is certainly not difficult, but I had noticed that the majority of my patients were very uncomfortable with the idea of getting an injection in the eye."

To use the device, the physician places the InVitria on the patient's eye with the help of a positioning line in the center that should be aligned with the limbus. Corneal diameter is not a factor, Dr. Gonçalves says, because positioning does not depend on the center or the size of the cornea. The physician then gently pushes down and rotates the device. This fixates the eye, and the patient feels an anesthetic effect due to the pressure. "Turning the InVitria causes displacement of the conjunctiva and gives a stepped injection hole after removing the needle," Dr. Gonçalves explains.

The eye is now immobilized — and the needle will not be visible to the patient during the injection, which Dr. Gonçalves says greatly reduces patient anxiety. Placing the needle through the guide tube ensures the proper angle, depth and distance from the limbus. The point of injection is always at 3.5mm from the orientation line. Turning the InVitria back again after removing the needle returns the displaced conjunctiva over the injection site to prevent any leakage.


The logistics of the traditional intravitreal injection method are inefficient, Dr. Gonçalves says. "For each traditional treatment, we have a surgical set that needs to be unpacked, stored and transported to sterilization after use. This consumes a lot of valuable time from my assistants and adds much work to the central sterilization department of my hospital due to the high volume of treatments performed." InVitria improves efficiency because it's disposable, fast, patient-friendly, "and most importantly it's safer than the traditional method," he says.

He also says an InVitria procedure is less costly than the traditional method. "If one accounts for the initial cost of the materials, sterilization costs, replacement of old and lost materials, the total cost per procedure of the traditional method is somewhere between $20 to $25, while InVitria costs approximately $10 per procedure."

Dr. Gonçalves has used the device for roughly 1000 procedures over the last two years. As there is no need for any other instrument like a speculum, caliper or pressure plate, he finds it reduces physician resistance to perform an injection. "With InVitria, the quality of the treatment has im proved tremendously, making the job more enjoyable and interesting not only for me, but also for my assistants, since our time is spent more on the patients and the procedures themselves rather than the logistics of it." RP

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