Cooling Anesthesia for Intravitreal Injection: Results of the Prospective Open-Label, Dose-Ranging COOL-1 Trial

Daniel L. Chao, Nicolas T. Rinella, Arshad M. Khanani, Charles C. Wykoff, Gun Ho Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the safety and efficacy of a novel medical device to provide cooling anesthesia to the eye as local anesthesia for intravitreal injections. Study Design: First in human, open-label study of 43 subjects assessed at three different doses: −10°C for 20 seconds (group 1), −15°C for 15 seconds (group 2), and −15°C for 20 seconds (group 3). Main outcome measures were safety and pain of injection using a numeric rating scale (NRS). Results: Cooling anesthesia did not result in any serious ocular adverse events. One grade 1 adverse event was a vasovagal response during cooling administration which resolved immediately after cooling. Mean NRS scores at the time of injection for each group ranged from 2.5 to 4.3 There was a statistically significant difference between pain scores of the 3 groups at injection in aggregate but not in pairwise comparisons (P value = 0.047). There was a statistically significant decrease in pain from injection to 5 minutes post injection in all groups (P value = 0.00008, 0.003, 0.0005 for groups 1, 2, 3, respectively) as well as from 5 minutes to 24–48 hours (P value = 0.00001, 0.018, and 0.0545 for groups 1, 2, 3, respectively). Conclusion: The rapid cooling anesthesia device was well tolerated for achieving local anesthesia among patients receiving intravitreal injections with no serious ocular adverse events.

Original languageEnglish (US)
Pages (from-to)4659-4666
Number of pages8
JournalClinical Ophthalmology
Volume15
DOIs
StatePublished - 2021

Keywords

  • Anesthesia
  • Cooling
  • Intravitreal injection
  • Pain

ASJC Scopus subject areas

  • Ophthalmology

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