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C. Y. Lowder, A. Galor, R. Margolis, R. Ufret-Vincenty, P. K. Kaiser; Complications of the Sustained-Release, Intravitreal, Fluocinolone Acetonide (RetisertTM) Implant. Invest. Ophthalmol. Vis. Sci. 2007;48(13):268.
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To report five patients with adverse ocular events not previously described after RetisertTM implantation: the formation of vitreous bands from the posterior pole to the implant (4 patients) and the development of cytomegalovirus retinitis (CMV, 1 patient).
Retrospective chart review of 33 patients who received a RetisertTM implant at the Cole Eye Institute.
Four patients (12%) developed vitreous bands to the implant that were visible on clinical examination. Vitreous bands were associated with a decrease in vision in three patients due to vitreous opacities and vitreomacular traction. In the two patients who underwent pars plana vitrectomy and membrane peel to release this traction, an improvement in best corrected visual acuity was seen, from 20/200 to 20/70 and 20/50, respectively. One patient (3%) with Behcet’s disease developed CMV retinitis five months after receiving a second RetisertTM implant. The patient was treated with a ganciclovir implant with complete resolution of CMV retinitis.
Vitreous bands to the implant and CMV retinitis were not noted in the 227 patients included in the original RetisertTM studies; however, patients in those studies were followed for only three years. Most of the patients in our study developed vitreous bands more than three years after implant placement when vitreous inflammation had recurred. CMV retinitis most likely developed secondary to local immunosuppression.
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