Comparison of the Syringe Preparation Time for Ranibizumab Prefilled Syringe versus Bevacizumab, Ranibizumab, and Aflibercept Vials

Objective: To compare the syringe preparation time for ranibizumab prefilled syringe versus bevacizumab, ranibizumab, and aflibercept vials in routine retinal practice. Methods: The study was conducted retrospectively between July 2019 and February 2021 at the Ophthalmology Department of the Erzincan Binali Yıldırım University Faculty of Medicine, Türkiye. Syringe preparation times for 157 eyes were collected for the study. For each injection, one independent observer recorded the duration of each step required to prepare the syringe, starting with the removal of the ranibizumab prefilled syringe or bevacizumab, ranibizumab, and aflibercept vials from their respective packaging, and ending at the moment the dose was ready for injection. Injections were excluded if disruptions during the drug administration process were due to external factors or if other errors occurred in measuring preparation time. In addition to preparation time, formation of air bubbles during syringe preparation was qualitatively observed. Results: Forty-five eyes were treated with the ranibizumab prefilled syringe, while bevacizumab, ranibizumab, and aflibercept vials were used to treat 40, 36, and 36 eyes, respectively. The mean injection preparation time was 46.5±4.8 s for the syringe and 66.1±7.2 s, 64.2±5.1 s, and 74.7±8.5 s for the bevacizumab, ranibizumab, and aflibercept vials, respectively. Air bubble formation was more frequently observed in the vial groups, particularly in the aflibercept group, than in the prefilled syringe group. Conclusion: The ranibizumab-prefilled syringe required fewer preparation steps and had a lower incidence of bubble formation compared with other vials. Specifically, when preparing the aflibercept vial for injection, dose adjustment took longer than for the bevacizumab and ranibizumab vials, primarily due to air bubbles.