Intravitreal fluocinolone acetonide implant for the treatment of persistent non-diabetic post-surgical cystoid macular edema in vitrectomized eyes.

Author: Lucía Miguel Escuder (Spain)

Co-authors: Álvaro Olate, Anna Sala, Aina Moll, Marc Figueras, Alfredo Adán, Laura Pelegrin

Purpose

Scarce reports in the literature described the use of the intravitreal fluocinolone acetonide implant (Iluvien ®) in the treatment of post-surgical cystoid macular edema (CME). The objective of this study is to describe the efficacy and safety of Iluvien® in the treatment of post-surgical CME in vitrectomized eyes in a single tertiary center.

Setting/Venue

CME is the most common cause of decreased visual acuity after both vitrectomy and cataract surgery. Various strategies have been used for its treatment, such as intravitreal corticosteroids. The intravitreal fluocinolone acetonide implant is approved for the treatment of persisting diabetic macular edema and for the prevention of recurrence of non-infectious uveitis affecting the posterior segment. There are very few reports about its off-label use for post-surgical CME.

Methods

Retrospective description of a case series.

Results

We present four clinical cases of post-surgical CME (three following vitrectomy and one following cataract surgery in a previously vitrectomized eye two years ago). All of them had been previously treated with an average of 4 injections of intravitreal dexamethasone implant (Ozurdex®), with repeated recurrence of CME. After treatment with Iluvien®, three cases showed improvement of both visual acuity and macular anatomy, with resolution of the macular edema. One patient required additional treatment with Ozurdex® during follow-up, further improving CME. Two of the cases required topical pressure lowering treatment, and none required filtering surgery.

Conlusions

Iluvien could be an effective therapeutic option for persistent non-diabetic macular edema after vitrectomy or cataract surgery refractory to other intravitreal therapies, with the benefit of being able to provide longer recurrence-free periods.

Financial Disclosure

The author(s) declared no potential conflicts of interest