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Ashleigh Laurin Levison, Sruthi Arepalli, Paula E Pecen, Careen Y Lowder, Sunil K Srivastava; Long-Term Outcomes for Patients Undergoing Fluocinolone Implant Placement. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1885.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the long-term outcomes of patients who underwent retisert placement for non-infectious uveitis.
This is an IRB approved, retrospective chart review of all patients who have undergone fluocinolone implant placement at the Cleveland Clinic from 2001 onward and have at least eight years follow-up.
Forty-one eyes of 34 patients underwent fluocinolone implant placement and had at least eight year follow-up. Twenty-six patients were female, 8 were male. The average age at the time of review was 59.9 years. 55% of the patients had idiopathic disease, 15% sarcoidosis, 12% birdshot, 6% Behcet’s disease, 6% multiple sclerosis associated uveitis, 3% HLA B27 associated uveitis, and 3% multifocal choroiditis and panuveitis. Eleven eyes received only 1 implant and 2 eyes had undergone four implants over the follow-up period. Average pre-op vision was 20/63 and average vision at last follow-up was 20/50, excluding the 2 eyes that had CF or worse vision pre-op, and the 3 that had CF or worse vision at last follow-up visit. Eleven eyes underwent post-implant phacoemulsification and intraocular lens placement. All other eyes were pseudophakic prior to implant placement; therefore all 100% were pseudophakic by the end of the follow-up period. Twenty-seven of the 41 eyes (66%) underwent glaucoma surgery, 9 had trabeculectomies, the rest underwent Ahmed valve placement. Two patients who had undergone trabeculectomies required a second glaucoma surgery. Complications included 1 retinal detachment, 1 CMV retinitis with subsequent detachment, 2 full-thickness macular holes, 3 epiretinal membranes, 1 central retinal vein occlusion, and 1 sterile endophthalmitis. 3 fluocinolone implants were removed, one due to loose sutures and two with associated scleritis, one of which extruded.
In a series of patients with at least 8 year follow-up for fluocinolone implant placement the average final vision vision was improved from pre-op vision. All patients became pseudophakic. 66% of patients required glaucoma surgery, with only 2 patients requiring a second glaucoma surgery. Complications occurred, but were uncommon. Fluocinolone implant placement is an important option for the treatment of non-infectious uveitis.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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