Combined Fluocinolone Acetonide Intravitreal Insertion and Glaucoma Drainage Device Placement for Chronic Uveitis and Glaucoma
Accepted 1 December 2009. published online 26 February 2010.
Refers to article:
Proof of Concept for Combined Insertion of Fluocinolone Acetonide and Glaucoma Drainage Implants for Eyes with Uveitis and Glaucoma
Husam Ansari, John H. Kempen
American Journal of Ophthalmology
May 2010 (Vol. 149, Issue 5, Pages 699-700) Full Text |
Full-Text PDF (80 KB)
Purpose
To determine whether a fluocinolone acetonide sustained-release intravitreal drug delivery system can be implanted safely at the same time that a glaucoma drainage device is placed for eyes with uveitis and elevated intraocular pressure (IOP) receiving maximum tolerated IOP-lowering therapy.
Design
Retrospective, observational case series.
Methods
Subjects had chronic noninfectious intermediate or posterior uveitis and elevated IOP while receiving maximum tolerated medical therapy. Fluocinolone acetonide implantation and glaucoma tube shunt placement were performed in a single surgical session. The main outcome measures were inflammatory recurrences, visual acuity (VA), use of adjunctive anti-inflammatory therapy, IOP, and adverse events.
Results
Seven eyes of 5 patients were studied. The average number of recurrences 12 months before implantation was 3 episodes per eye; of the 3 eyes followed up for more than 30 months, none had an inflammatory recurrence within 30 months after implantation. The mean Snellen visual acuity 12 months after the combined surgery was 20/114, compared with 20/400 at baseline. Adjunctive steroid use decreased. Average IOP decreased from 27.3 mm Hg at baseline to 14.6 mm Hg 12 months after the combined surgery (P = .019).
Conclusions
The favorable results observed in all eyes suggest that fluocinolone acetonide implantation can be safely combined with glaucoma tube shunt placement in a single surgical session in eyes with uveitis and elevated IOP receiving maximum tolerated IOP-lowering therapy. Uveitis recurrences decreased, visual acuity improved, and IOP decreased. There were no adverse events during insertion of the fluocinolone acetonide implant and placement of the glaucoma tube shunt.
Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
Inquiries to Glenn J. Jaffe, Duke University Eye Center, Erwin Road, P. O. Box 3802, Durham, NC 27710
ABSTRACT