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Risk of dissociation with Retisert implant increases over time
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The risk for Retisert implant dissociation increases the longer the implant is in the eye, according to a study.
Follow-up data of 250 first implants with Retisert (fluocinolone acetonide, Bausch + Lomb) were culled from the Multicenter Uveitis Steroid Treatment (MUST) trial,
a randomized controlled clinical trial and follow-up of patients with noninfectious uveitis for whom corticosteroids were given between 2001 and 2015. The purpose of the present study was to describe implant dissociation in the implanted patients as defined as “the drug pellet no longer being affixed to the strut.”
Median time for follow-up after implantation was 6 years.
Results showed that dissociation occurred more frequently in implants that were in place for longer periods. In the 250 first implants in 146 patients, 34 dissociations were reported in 30 patients. Twenty-two of these were spontaneous events that occurred in 22 patients between 4.8 and 8.6 years, with cumulative risk for spontaneous dissociation in the median follow-up time being 4.8%.
“We found the rate of spontaneous dissociation and dislocation to be low...and to increase with time since implant placement,” the authors wrote, adding that these drug pellets were likely empty considering the therapeutic effectiveness for the implant is 2.5 years.
Decline in visual acuity (VA) averaged 15 or more letters from pre-implant VA in 22% of eyes that experienced implant dissociation, which was not unexpected in uveitic eyes, according to the report. The authors acknowledged that the implant had been re-engineered in 2011 to strengthen the strut/pellet attachment and that more experience with the redesigned implant is needed. – by Patricia Nale, ELS, and Kate Sherrer
Disclosures: Jabs reports he is a consultant for Applied Genetic Technologies and Santen; Thorne reports she is a consultant for AbbVie, Xoma and Gilead and receives grant support from Allergan; Vitale reports he is a consultant for Alcon. All other authors report no relevant financial relationships.
Collapse
Holbrook JT, et al. Am J Ophthalmol. 2016;doi:10.1016/j.ajo.2015.12.028.
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