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Dong Hyun Kim, Bum-Joo Cho, Hum Chung, Jang won Heo; Intravitreal injection of dexamethasone implant during cataract surgery in patients with noninfectious uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):110.
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To investigate the efficacy and safety of intravitreal dexamethasone implant in controlling postoperative inflammation among uveitis patients undergoing cataract extraction
From July 2012 to June 2013, 7 patients with noninfectious uveitis underwent phacoemulsification with intraocular lens implantation, followed by intravitreal injection of 0.7-mg dexamethasone implant (Implant group). Twelve age-, sex-, and diagnosis- matched controls, who received cataract surgery during the same period without implantation, were recruited (Non-implant group). Medical records of these subjects were retrospectively reviewed, and postoperative clinical outcomes until 6 months were compared between two groups.
Mean subject age was 36.9+-16.0 in the Implant group and 38.6+-15.2 in the Non-implant group. Two groups were comparable with regard to age, sex, preoperative inflammatory status, and preoperative visual acuity (p=0.738, 0.874, 0.307, and 0.456, respectively). After surgery, oral steroid of 13.95mg/day in average was used in the Non-implant group, whereas only 4.58mg/day oral steroid was used in the Implant group (p=0.036). Visual acuity (logMAR) improved significantly in both groups (p=0.874) with no significant difference between two groups. Postoperative recurrence rates of uveitis were reduced (14.3%) in the Implant group than in the Non-implant group (66.7%) with a marginal significance (p=0.057). Intraocular pressure elevation ≥25mmHg occurred in 2 (28.6%) in the Implant group and 4 (33.3%) in the Non-implant group (p=1.000), of which 1 of the Implant group required a filtering surgery. Otherwise, no significant complication developed in both groups.
Anti-inflammatory efficacy of dexamethasone intravitreal implant was, despite the reduction in the concurrently used oral steroid, equal or superior to that of conventional dose of oral steroid. Dexamethasone implant could be an effective and safe alternative to control the inflammation after cataract surgery in uveitis patients.
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