Clinical evaluation of efficacy and safety of proxymetacaine hydrochloride 0.5% in intravitreal administration of angiogenesis inhibitors

    Abstract

    Original article

    Clinical evaluation of efficacy and safety of proxymetacaine hydrochloride 0.5% in intravitreal administration of angiogenesis inhibitors

    N.V. Postupaeva, M.V. Pshenichnov, L.A. Golota, A.V. Postupaev

    S. Fyodorov Eye Microsurger y Federal State Institution, Khabarovsk branch, Khabarovsk, Russian Federation
Institute for Advanced Studies of Healthcare Professionals, Khabarovsk, Russian Federation
Far-Eastern State Medical University, Khabarovsk, Russian Federation

    PRelevance. Local topical anesthesia is widely used in ophthalmology for ophthalmic surgery, including intravitreal angiogenesis inhibitor (IVAI) injections. the need for regular IVAI poses the challenge for ophthalmologists to ensure maximum patient comfort and minimize pain during the procedure.

    Purpose. To evaluate the clinical efficacy and safety of using proxymetacaine hydrochloride 0.5% in IVAI.

    Material and methods. Forty patients (40 eyes) undergoing IVAI for the first time. The average age was 69.4±4.1 years. In addition to the main ophthalmological examination methods, patients were surveyed to assess subjective complaints and pain intensity using the VAS (Visual Analogue Scale). The quality of anesthesia was assessed using the TSS (Total Symptom Score). The speed of onset of complete anesthesia, the presence of sensitivity during surgery, the duration of anesthesia, and adverse reactions were assessed. Before IVAI, all 40 patients received local anesthesia in the form of 0.5% proxymetacaine hydrochloride drops (Dropstetic®, Grotex LLC, Russia).

    Results. The onset of complete anesthesia was 60–110 sec, with an average of 72.45±18.9 sec. According to the TSS scale, 31 patients (77.5%) achieved a score of 0 points 2 minutes after anesthetic instillation, 7 patients (17.5%) achieved a score of 1 point, and 2 patients (5%) achieved a score of 2 points. According to the patient survey using the VAS scale, the majority of patients — 29 (72.5%) — experienced no pain or mild pain (from 0 to 2 points) during IVAI. Nine patients (22.5%) experienced 3–4 points (moderate pain) during treatment. Two patients (5%) rated the pain as severe with a score of 6. No patients gave a score of 7–10 points (very severe pain and unbearable pain). The average score was 1.9±1.7. The duration of action of proxymetacaine hydrochloride 0.5% (full anesthesia) was 12–18 minutes, with an average of 14.3±2.8 minutes. Minor side effects (short-term burning or stinging in the eye, conjunctival hyperemia) were transient and did not require additional treatment.

    Conclusion. Proxymetacaine hydrochloride 0.5% is an effective and safe local anesthetic for IVAI, provides rapid onset of complete anesthesia, does not cause serious side effects and can be recommended for widespread use in clinical practice.

    Keywords: intravitreal injection of angiogenesis inhibitors, local anesthesia, proxymetacaine hydrochloride 0.5%, macular edem

    For citation: Postupaeva N.V., Pshenichnov M.V., Golota L.A., Postupaev A.V. Clinical evaluation of efficacy and safety of proxymetacaine hydrochloride 0.5% in intravitreal administration of angiogenesis inhibitors. Fyodorov Journal of Ophthalmic Surgery. 2025;4(147): 79–84.

    DOI: 10.25276/0235-4160-2025-4-79-84

    Corresponding author: Natalia V. Postupaeva, naukakhvmntk@mail.ru