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Rebekah C. Allen, Christina J. Flaxel, Eric B. Suhler; Fluocinolone Acetonide Intravitreal Implant Exchange: Long-term Follow-up of Fluocinolone Acetonide Implants for the Treatment of Non-Infectious Posterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2731.
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To study fluocinolone acetonide intravitreal implant exchange with replacement of depleted implants in the treatment of non-infectious posterior uveitis.
A single center, retrospective chart review was conducted on all fluocinolone acetonide intravitreal implants placed from 2007 to 2010. Of the 23 eyes identified by the study, seven eyes received fluocinolone acetonide intravitreal implants as an exchange for depleted implants. These 7 eyes were further reviewed to determine long-term complications including recurrence of inflammation, need for concurrent local and systemic immunosuppression, and glaucoma and cataract formation.
The recurrence of uveitis was noted in 2 of the 7 implanted eyes during the follow-up period and this was controlled with systemic immunosuppression in both cases. The remaining 5 patients did not experience recurrence of inflammation and were not on systemic immunosuppression at the time of last follow-up. Glaucoma developed in 5 of the implanted eyes without a previous history of glaucoma. Of these, there was a need for a filtering surgery in 3 of the eyes during the first implantation period and 1 of the eyes during the second implantation period. Visually significant cataracts were surgically removed in 5 of the 5 phakic eyes during the first implantation period.
The exchange of depleted fluocinolone acetonide intravitreal implants for the treatment of non-infectious posterior uveitis may be useful in preventing recurrence of inflammation after depletion of the initial implant. This may also be helpful in preventing the need for systemic immunosuppression. A significant number of patients treated with sequential implants required surgical treatment of subsequent glaucoma and cataracts. The majority of these treatments were necessary during the first implantation period and may not be as significant of a complication during the second implantation period. Long-term control of intraocular inflammation can be achieved with minimal complications in uveitic eyes achieving good control of inflammation with an initial fluocinolone intravitreal implant who undergo an implant exchange.
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