{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T16:28:31Z","timestamp":1793896111417,"version":"4.8.0"},"reference-count":12,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>In 2024, the American Society of Retina Specialists (ASRS) Research and Safety in Therapeutics (ReST) Committee became aware of reports of coring of vial stoppers in relation to preparation of intravitreal injections. A literature review was performed to further understand and characterize this occurrence within the context of retina practice and the broader medical community. Relevant articles were identified through a systematic search of PubMed using predefined criteria. Coring can be observed when a needle punctures the rubber stopper of a medication vial, pushing a small piece or pieces of the stopper material into the container and introducing extrinsic particles into the drug product. Factors associated with coring include larger gauge needles, perpendicular needle entry, multiple-use vials, and thicker rubber stoppers. Rubber stopper thickness and composition also influence the likelihood of coring. To prevent patient safety issues from coring, filter needles are commonly used to draw up medications from vials because they are effective in mitigating particulate matter from entering syringes. No documented cases of clinical complications related to coring in ophthalmology have been identified. Coring represents an unreported phenomenon in the preparation of intraocular medications. Although there have been no safety implications in retina practice related to coring and intravitreal drug vials, these reports underscore the importance of careful medication preparation, inspection of vials, the use of appropriate needles, and adherence to best clinical practices.<\/jats:p>","DOI":"10.1177\/24741264251356296","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T12:17:19Z","timestamp":1752495439000},"page":"546-549","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Coring of Intravitreal Medication Vial Stoppers: A Report From the Research and Safety in Therapeutics Committee of the American Society of Retina Specialists"],"prefix":"10.1177","volume":"9","author":[{"given":"Ferhina S.","family":"Ali","sequence":"first","affiliation":[{"name":"New York Medical College, Valhalla, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Tennessee Retina, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sruthi","family":"Arepalli","sequence":"additional","affiliation":[{"name":"Emory Eye Center, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durga","family":"Borkar","sequence":"additional","affiliation":[{"name":"Duke University Eye Center, Duke University, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3899-4456","authenticated-orcid":false,"given":"Jordan D.","family":"Deaner","sequence":"additional","affiliation":[{"name":"Mid Atlantic Retina, Wills Eye Hospital, Philadelphia, PA, USA"},{"name":"Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieraj","family":"Jain","sequence":"additional","affiliation":[{"name":"Emory Eye Center, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolas J.S.","family":"London","sequence":"additional","affiliation":[{"name":"Retina Consultants of San Diego, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-846X","authenticated-orcid":false,"given":"Ivan J.","family":"Suner","sequence":"additional","affiliation":[{"name":"Retina Associates of Florida, Tampa, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay S.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Tennessee Retina, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lejla","family":"Vajzovic","sequence":"additional","affiliation":[{"name":"Duke University Eye Center, Duke University, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin A.","family":"Vora","sequence":"additional","affiliation":[{"name":"Kaiser Permanente, Oakland, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3001-8098","authenticated-orcid":false,"given":"Andre J.","family":"Witkin","sequence":"additional","affiliation":[{"name":"Ophthalmic Consultants of Boston, Boston, MA, USA"},{"name":"Tufts Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"1533","article-title":"A case of the foreign body due to \u201ccoring\u201d","volume":"45","author":"Sakai T","year":"1996","unstructured":"Sakai T, Koh H, Matsuki A. A case of the foreign body due to \u201ccoring\u201d. Masui. 1996;45:1533-1535.","journal-title":"Masui"},{"issue":"9","key":"e_1_3_2_3_2","article-title":"Coring revisited: a case report and literature review","volume":"14","author":"Hruska JL","year":"2022","unstructured":"Hruska JL, Saasouh W, Alhamda MS. Coring revisited: a case report and literature review. Cureus. 2022;14(9):e29750.","journal-title":"Cureus"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2015.01.009"},{"issue":"4","key":"e_1_3_2_5_2","first-page":"165","article-title":"Rubber coring of injectable medication vial stopper: an evaluation of causal factors","volume":"1","author":"Chennell P","year":"2016","unstructured":"Chennell P, Bourdeaux D, Citerne Q, et al Rubber coring of injectable medication vial stopper: an evaluation of causal factors. Pharm Technol Hosp Pharm. 2016;1(4):165-174.","journal-title":"Pharm Technol Hosp Pharm"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s005400170042"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"10","article-title":"The use of blunt needles to prevent needle-stick injuries","volume":"12","author":"Wright L.","year":"1993","unstructured":"Wright L. The use of blunt needles to prevent needle-stick injuries. J Med Saf. 1993;12(1):10-15.","journal-title":"J Med Saf"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2005.09.012"},{"issue":"3","key":"e_1_3_2_9_2","first-page":"169","article-title":"Assessing blunt cannulae as replacements for hypodermic needles during intravenous therapy: safety and utility","volume":"18","author":"Kempen PM.","year":"1997","unstructured":"Kempen PM. Assessing blunt cannulae as replacements for hypodermic needles during intravenous therapy: safety and utility. Infect Control Hosp Epidemiol. 1997;18(3):169-174.","journal-title":"Infect Control Hosp Epidemiol"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2013.10.007"},{"issue":"6","key":"e_1_3_2_11_2","first-page":"1902","article-title":"Near-miss events and coring risks with blunt needles","volume":"107","author":"Riess E.","year":"2000","unstructured":"Riess E. Near-miss events and coring risks with blunt needles. Anesth Analg. 2000;107(6):1902-1905.","journal-title":"Anesth Analg"},{"issue":"2","key":"e_1_3_2_12_2","first-page":"101","article-title":"Coring and multi-use vials: an analysis of rubber fragmentation","volume":"45","author":"Chotikawanich P.","year":"2021","unstructured":"Chotikawanich P. Coring and multi-use vials: an analysis of rubber fragmentation. 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