Outcome of Fluocinolone Acetonide Implant (RetisertTM) Re-Implantation for Chronic Non-Infectious Posterior Uveitis

Abstract

Purpose: : To evaluate outcome of repeat intravitreal fluocinolone acetonide implant (Retisert^TM) in patients with chronic non-infectious posterior uveitis.

Methods: : Retrospective review of 10 eyes (10 patients) with recurrent non-infectious posterior uveitis who underwent a 2^nd Retisert implant in the same eye. Recurrence rate of ocular inflammation in the implanted eye was evaluated before and after the 1^st and 2^nd implants. Surgical complications, visual acuity (VA) changes, need for adjunctive therapy, and safety were also assessed.

Results: : After 1^st Retisert implantation, the VA was stable or improved in 100% of patients and the median time to first recurrence was 32.5 months (range, 17.5-54 months). After 2^nd implantation, the median follow-up was 16.8 months, the VA was stable or improved in 100% of patients, and only 4 eyes had recurrences during the follow-up period (median 18.3 months, range 11-29.5 months). Of the 4 phakic eyes prior to 1^st implant, all had underwent cataract extraction (range 8.5 to 16.5 months). Five eyes required glaucoma surgery after the 1^st implant and one eye after the 2^nd implant. Other complications included one case of vitreous hemorrhage after 1^st implant and one rhegmatogenous retinal detachment (RRD) at the site of 2^nd implant.

Conclusions: : Retisert re-implantation for chronic non-infectious posterior uveitis offers similar control of ocular inflammation as the 1^st implantation with recurrence occurring at approximately 1.5 to 2 years. Complications in the second implant are similar to those reported after primary implantation.

Keywords: chorioretinitis • uvea • retinochoroiditis