Optimizing Aqueous Humor Liquid Biopsy: Safety and Performance of a Short, Low-Dead-Space Ophthalmic Needle for Anterior Chamber Paracentesis
- 1Molecular Surgery Laboratory, Stanford University, Palo Alto, California, USA; Department of Ophthalmology, Byers Eye Institute, Stanford University School of M
Abstract
PurposeTo evaluate the safety, procedural performance, sample recovery, and surgeon preference of an ophthalmic needle designed specifically for anterior chamber (AC) paracentesis.
MethodsIn this multicenter study, AC paracentesis was performed in clinic and operating-room settings using a 32-gaugex 4-mm needle with low dead space. The procedure was evaluated using a standardized physician survey. Prespecified outcomes included procedure-related adverse events (primary outcome), needle entry and handling, aspiration and sample recovery, comparative performance versus a 30-gauge needle, and physician preference for future use.
ResultsA total of 110 needle uses by eight surgeons were included. No ocular complications occurred, including lens or iris injury, hyphema, AC collapse, wound leak, hypotony, infection, or retinal complication, and no procedure required needle exchange or conversion to another device. Two technical events without ocular sequelae were noted, in which needle entry was partial thickness and did not reach the AC (1.8%; exact 95% CI, 0.2%-6.4%). Physicians rated needle entry, handling, and sample recovery as good or excellent. Compared with a 30-gauge needle, the study needle was rated as at least comparable across all assessed domains. All surgeons rated it better or much better for intra-procedural safety and preferred it for future AC taps.
Conclusions and RelevanceThis short, 32-gauge low-dead-space ophthalmic needle demonstrated a favorable safety profile and was preferred over a 30-gauge needle by all surgeons. As aqueous humor liquid biopsy expands in clinical diagnostics and trials, an ophthalmic-specific needle design may help improve the consistency and safety of aqueous humor collection for molecular analysis and broader clinical use.
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BibTeX
@misc{singh2026optimizing,
title = {{Optimizing Aqueous Humor Liquid Biopsy: Safety and Performance of a Short, Low-Dead-Space Ophthalmic Needle for Anterior Chamber Paracentesis}},
author = {A. M. Singh and T.-C. Yeh and C. DeBoer and A. Al-Moujahed and J. B. Lin and S. J. Smith and S. Sanislo and K. A. Janjua and T.-C. Lin and D. R. P. Almeida and P. Mruthyunjaya and V. B. Mahajan},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.26.26361364},
url = {https://www.medrxiv.org/content/10.64898/2026.08.26.26361364v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Optimizing Aqueous Humor Liquid Biopsy: Safety and Performance of a Short, Low-Dead-Space Ophthalmic Needle for Anterior Chamber Paracentesis
AU - A. M. Singh
AU - T.-C. Yeh
AU - C. DeBoer
AU - A. Al-Moujahed
AU - J. B. Lin
AU - S. J. Smith
AU - S. Sanislo
AU - K. A. Janjua
AU - T.-C. Lin
AU - D. R. P. Almeida
AU - P. Mruthyunjaya
AU - V. B. Mahajan
PY - 2026
DA - 2026/08/26
PB - medRxiv
DO - 10.64898/2026.08.26.26361364
UR - https://www.medrxiv.org/content/10.64898/2026.08.26.26361364v1
AB - PurposeTo evaluate the safety, procedural performance, sample recovery, and surgeon preference of an ophthalmic needle designed specifically for anterior chamber (AC) paracentesis. MethodsIn this multicenter study, AC paracentesis was performed in clinic and operating-room settings using a 32-gaugex 4-mm needle with low dead space. The procedure was evaluated using a standardized physician survey. Prespecified outcomes included procedure-related adverse events (primary outcome), needle entry and handling, aspiration and sample recovery, comparative performance versus a 30-gauge needle, and physician preference for future use. ResultsA total of 110 needle uses by eight surgeons were included. No ocular complications occurred, including lens or iris injury, hyphema, AC collapse, wound leak, hypotony, infection, or retinal complication, and no procedure required needle exchange or conversion to another device. Two technical events without ocular sequelae were noted, in which needle entry was partial thickness and did not reach the AC (1.8%; exact 95% CI, 0.2%-6.4%). Physicians rated needle entry, handling, and sample recovery as good or excellent. Compared with a 30-gauge needle, the study needle was rated as at least comparable across all assessed domains. All surgeons rated it better or much better for intra-procedural safety and preferred it for future AC taps. Conclusions and RelevanceThis short, 32-gauge low-dead-space ophthalmic needle demonstrated a favorable safety profile and was preferred over a 30-gauge needle by all surgeons. As aqueous humor liquid biopsy expands in clinical diagnostics and trials, an ophthalmic-specific needle design may help improve the consistency and safety of aqueous humor collection for molecular analysis and broader clinical use.
ER -