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D. Callanan, C. Fuller, T. A. Landry, J. E. Dickerson, M. V. W. Bergamini; Prophylactic Anecortave Acetate in Patients With a Retisert Implant. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5630.
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The Retisert implant 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) following implantation in 60% of patients. Glaucoma filtering is required in over 30% of patients at 2 years. Anecortave acetate (AA) has been shown to reduce steroid induced elevated IOP. The purpose of this study was to evaluate the ability of prophylactic anterior juxtascleral depot administration of AA to prevent this Retisert induced elevated IOP.
Consecutive patients implanted with a Retisert received one of three doses of anecortave acetate within two months of Retisert implantation. Either 12mg, 24 mg, or 30 mg was injected in the inferior juxtascleral position and this was repeated every 4 months. Goldmann applanation tonometry was performed monthly on all patients.
Eleven eyes of 10 patients have been enrolled in the study. Eight eyes have at least 9 months follow-up (range 9-14). The remaining 3 eyes have less than 6 months follow-up. The current mean IOP is 17 (range 13-21). Only two patients have required topical glaucoma drops, one of which had an IOP of 30 prior to the first AA anterior juxtascleral depot injection and the other received the lowest dose of AA (12 mg). No patient has required filtering surgery to lower the IOP, although one patient has had cataract surgery and a prophylactic trabeculectomy was performed at the same time (month 9).
It is still early in the post-Retisert course of these patients, but IOP has been controlled in all of the patients without the need for glaucoma filtering surgery. The patients will be followed for 3 years from the time of Retisert placement.
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