Implant safe in treating uveitis despite complications

FORT LAUDERDALE, Fla. — A corticosteroid implant proved safe and effective for the treatment of noninfectious posterior or intermediate uveitis, according to a poster presented here.

Maria Jancevski, MD, and colleagues reported results from the Retisert fluocinolone acetonide implant (Bausch + Lomb) at the Association for Research in Vision and Ophthalmology meeting.

"The Retisert implant is a generally well-tolerated device that enables long-term corticosteroid treatment of noninfectious inflammation," the study authors said. "The device demonstrates a role in the decreased dependence on, and even potential discontinuation, of systemic immunotherapy for the treatment of uveitis. However, potential complications including elevated intraocular pressure are common."

The retrospective study included 64 eyes of 51 patients. Investigators evaluated visual acuity, IOP, indications for treatment, medication use and complications. Primary outcome measures were need for continued immunotherapy and/or corticosteroid therapy, treatment of elevated IOP and potential complications. Patient follow-up ranged from 3 months to 3 years.

Study results showed that nine patients tolerated a decrease or discontinuation of existing immunotherapy after implantation. One patient required a second implant for treatment of recurrent inflammation after the first implant's drug supply was depleted.

Thirty eyes required additional topical treatment for elevated IOP; 14 eyes needed laser treatment, trabeculectomy or tube shunt placement.

Eleven of 14 phakic eyes required cataract surgery during follow-up. Complications included vitreous hemorrhage in eight eyes, retinal detachment in four eyes, infectious endophthalmitis in one eye and blebitis in one eye, the authors said.

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