The rise of anti-VEGF injections has provided new treatment possibilities for countless patients, but also delivered a new challenge: more people need injections than ever before.
The SP.Eye is a relatively new device in Australia and New Zealand, developed by an Ophthalmologist to make injections safer, quicker and more comfortable for patients.
For this article, mivision spoke to Dr Sam Evans, the inventor of SP.Eye about why he believes this device represents a significant advancement for anti-VEGF delivery. We also spoke to Sydney based ophthalmologist Dr Brian Harrisberg regarding his experience with SP.Eye in his clinics.
My hope is that devices like SP.Eye will allow the majority of injections to be done outside of the hospital, freeing up resources and helping more people maintain their vision for longer
Dr Evans on Developing SP.Eye
Q. What inspired you to invent the SP.Eye?
When I was a junior trainee, I would spend entire days in a small room doing nothing but injections. It was obvious to me that the number of injections was only ever going to increase and that having only doctors delivering these injections was unlikely to remain sustainable. I also recognised that the delivery method needed to be more comfortable for the patient, faster and less wasteful. No one likes having intravitreal injections – the speculum is painful, and the draping is time-consuming, leading to an experience that is more stressful than it should be for both patients and doctors.
Q. What were you hoping to achieve?
Back then, an injection would often take 20 minutes because of draping and checks. I wanted to design a simple device to make them safe and repeatable so that other health professionals could deliver them – freeing up doctors to make clinical decisions and helping to support a more efficient service. I forged relationships with a medical device consultant and a product designer. Together, we founded a company around the intellectual property (IP),and licensed the design for manufacture. In 2015, the SP.Eye intravitreal injection device was granted its CE mark and, since then the device has been distributed around Europe, the United Kingdom and Australasia.
Q. What makes SP.Eye unique?
The device is designed so that the needle goes into exactly the right place every time in a safe and repeatable manner. SP.Eye is the only sharps safe intravitreal injection device in the world. Nearly all of my patients remark that they prefer having their injections with SP.Eye. They are often surprised that the injection is so fast and pain free.
For clinics, SP.Eye increases efficiency. I would argue that you could probably see 25-30% more patients per clinic. That translates to fewer delays in the whole system, lowered intervals between injections for individuals, and, ultimately, better preservation of visual function for more people.
SP.Eye will also allow injections to be given outside the hospital, such as in nursing homes. In other words, we can aspire to take care of people in the community. This mindset is crucial for the future of ophthalmology. My hope is that devices like SP.Eye will allow the majority of injections to be done outside of the hospital, freeing up resources and helping more people maintain their vision for longer.
My patients prefer having injections with SP.Eye as they find injections more comfortable with the device and stress-free
Dr Harrisberg on Using SP.Eye
Q. When did you start using SP Eye and why?
I started using the SP.Eye intravitreal injection device at the end of 2023. The product is relatively new in Australia and New Zealand although it is well established in the United Kingdom, Europe and other parts of the world. I liked the fact that SP.Eye significantly reduces the amount of medical waste as less items are needed to perform intravitreal injections compared to traditional intravitreal injection kits.
Q. How do you use SP.Eye in clinic?
I do not use a speculum or drape and the SP.Eye fits seamlessly into this technique. After standard drop preparation with local anaesthetic and topical chlorhexidine, I dip the device foot plate into chlorhexidine antiseptic and then ask the patient to look down. I retract the upper lid using a needle cap. This exposes the superior sclera. Next, I line up the arc-like device with the limbus and press down and simultaneously inject.
Q. What difference do you believe it makes?
“I believe that the device may reduce the risk of contamination as the needle tip is never exposed. The device also makes injections easy to perform without a speculum, which reduces possible meibomian gland secretions and contaminants from these secretions and the lid margins. There is also less chance of a corneal abrasion occurring when a speculum is not used. My patients find the device comfortable.”
Q. From a procedural perspective, what do you like most about using the SP.Eye?
The needle goes into exactly the right place every time; it is always 4 mm from the limbus and the depth of the injection is always 6.5 mm. The angle of the injection is fixed and allows me to avoid the back of the crystalline lens. All of these design features allow me to perform injections one handed while retracting the upper lid with a needle cap in the other hand. The arc-like foot plate allows different injection sites over an arc by rotating the device and avoiding re-injections in the same position. This may be a safety advantage.
Another feature of the design is that it is sharps safe; the needle tip is tucked away and inaccessible. My patients prefer having injections with SP.Eye as they find injections more comfortable with the device and stress-free. They are pleasantly surprised how quick the procedure is with SP.Eye.
Dr Sam Evans MBS BSc is a consultant eye surgeon from the United Kingdom. He specialises in high volume cataract surgery, oculoplastics and glaucoma. Sam is particularly interested in innovative approaches to delivering high quality eye care and runs several businesses which aim to improve the access to and delivery of efficient services.
Dr Brian Harrisberg MBBCh, FRACS, FRANZCO has practiced as an ophthalmologist for over 30 years and has special interests in refractive surgery, corneal laser eye surgery and cataract surgery using implantable devices to enhance vision. He is a leading expert in surgery to correct refractive errors and has pioneered several surgical procedures in Australia.
