Purchase this article with an account.
D. Callanan, T. Landry, J. Dickerson, M. Bergamini; Prophylactic Anecortave Acetate in Patients With a Retisert Implant. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2692.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The Retisert implant (0.59 mg) is an effective therapy for controlling inflammation in patients with non-infectious posterior uveitis. One of the major complications of this device is the development of elevated intraocular pressure (IOP) in 66% of patients following implantation. Glaucoma filtering is required in 32% of patients at 3 years. We have previously reported early results using Anecortave acetate (AA) to prevent Retisert induced IOP elevation.1 The purpose of this report is to provide follow-up data in these patients post-Retisert implantation.
Consecutive patients implanted with Retisert received one of three doses of AA within two months of Retisert implantation. Either 12 mg, 24 mg, or 30 mg (volume 0.2-0.5 ml of a 6% solution) was injected in the inferior juxtascleral position and this was repeated every 4 months. The dose was increased to 48 mg for two patients after the 4th injection due to elevated IOP. Goldmann applanation tonometry was performed monthly on all patients.
Thirteen eyes of 12 patients were enrolled. Eleven eyes have at least 12 months follow-up and 2 eyes have reached 24 month followup (range 9-24; mean = 18 mos; median = 20 months). The current mean IOP is 15 mm Hg (range 7-22). Only three patients have required topical glaucoma drops and one patient has required filtering surgery to lower the IOP (IOP at time of enrollment was 30). The rate of elevated IOP at one year is 3/11 (27%) versus the reported rate of 58% in the original Retisert trial.2
A significant percentage of patients with a Retisert implant develop elevated IOP between 6 and 12 months after implantation.2 Prophylactic treatment with AA appears to substantially reduce this risk associated with Retisert. IOP has been controlled without the need for glaucoma filtering surgery in all but one of the patients. The patients will continue to be followed for 3 years from the time of Retisert placement.
Clinical Trial: :
This PDF is available to Subscribers Only