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Insulin syringe for anesthesia in ptosis surgery: a randomized, fellow eye-controlled clinical study

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Abstract

Purpose

Unlike ordinary 30-gauge needles, insulin syringe needles are thinner and shorter and have a comparatively blunt tip. Therefore, insulin syringes may reduce injection discomfort, bleeding, and edema by minimizing tissue damage and vascular penetration. This study aimed to evaluate the potential benefits of using insulin syringes for local anesthesia in ptosis surgery.

Methods

This randomized, fellow eye-controlled study included 60 patients (120 eyelids), conducted at a university-based hospital. An insulin syringe was used on one eyelid, and a conventional 30-gauge needle was used on the other. Patients were instructed to score pain in both eyelids using a visual analog scale (VAS) ranging from 0 (no pain) to 10 (unbearable pain). Ten minutes after the injection, two observers scored degrees of hemorrhage and edema in both eyelids on five- and four-pointing grading scales (0–4 and 0–3) for each value, and the average score between the two observers was calculated and compared.

Results

The VAS score was 5.17 in the insulin syringe group and 5.35 in the 30-gauge needle group (p = 0.282). Ten minutes after the anesthesia, the median hemorrhage scores were 1.00 and 1.75 (p = 0.010), and the median eyelid edema scores were 1.25 and 2.00 (p = 0.007) in the insulin syringe and 30-gauge needle groups, respectively (Fig. 1).

Conclusion

Injecting local anesthesia using an insulin syringe significantly reduces hemorrhage and eyelid edema, but not injection pain, before skin incision. Insulin syringes are useful in patients at high risk of bleeding because they can reduce the penetrative tissue damage caused by needle insertion.

Schematic abstract of patient enrollment, comparison, and result analysis

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Data availability

The datasets obtained and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This study was supported by Grant No. 2017-01 from the Kangdong Sacred Heart Hospital Fund.

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Author notes

  1. Chan Woong Joo and Won Seok Song have contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Kangdong Sacred Heart Hospital, Seoul, Korea

    Chan Woong Joo, Won Seok Song & Youn Joo Choi

  2. Department of Ophthalmology, Hallym Sacred Heart Hospital, Anyang, Korea

    Min Joung Lee

  3. Department of Ophthalmology, College of Medicine, Hallym University, Chuncheon, Korea

    Min Joung Lee & Youn Joo Choi

Authors
  1. Chan Woong Joo
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  2. Won Seok Song
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  3. Min Joung Lee
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  4. Youn Joo Choi
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Contributions

Research conception and design contributed by WSS and YJC. Data acquisition contributed by WSS, CWJ, and YJC. Data analysis and interpretation contributed by CWJ, MJL, and YJC. Statistical analysis contributed by WSS and YJC. Drafting the manuscript contributed by WSS and CWJ. Critical revision of the manuscript contributed by MJL and YJC. All authors approved the final manuscript.

Corresponding author

Correspondence to Youn Joo Choi.

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Conflict of interest

The authors declare that there are no conflict of interest regarding the publication of this article.

Ethics approval

This study adhered to the Helsinki Declaration and was approved by the Institutional Review Board of the Kangdong Sacred Heart Hospital (approval no. 2017-05-003).

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Informed consent was submitted by all subjects when they were enrolled.

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Joo, C.W., Song, W.S., Lee, M.J. et al. Insulin syringe for anesthesia in ptosis surgery: a randomized, fellow eye-controlled clinical study. Int Ophthalmol 43, 2721–2730 (2023). https://doi.org/10.1007/s10792-023-02671-9

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  • DOI: https://doi.org/10.1007/s10792-023-02671-9

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