Anterior segment complications after dexamethasone implantations:real world data

• Published in: International ophthalmology Vol. 43; no. 11; pp. 4279 - 4287
• Main Authors: Ayaz, Yusuf, Erkan Pota, Çisil, Başol, İbrahim, Doğan, Mehmet Erkan, Türkoğlu Şen, Elif Betül, Ünal, Mustafa
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-11-2023; Springer Nature B.V
• Subjects: Anterior chamber; Cataracts; Complications; Dexamethasone; Diabetes mellitus; Edema; Endophthalmitis; Eye; Glaucoma; Hypertension; Implants; Injection; Intraocular pressure; Medicine; Medicine & Public Health; Occlusion; Ophthalmology; Original Paper; Patients; Retina; Safety; Segments; Side effects; Statistical analysis; Transplants & implants; Uveitis; Veins; Glaucoma; Intravitreal dexamethasone; Retinal vein occlusion; Cataract; Diabetes; Ozurdex
• ISSN: 1573-2630; 0165-5701; 1573-2630
• DOI: 10.1007/s10792-023-02838-4

Purpose
We aim to contribute to the literature in terms of treatment safety with our real world data by examining the anterior segment complications and follow-up results of patients who underwent dexamethasone implants in our clinic.
Methods
The records of patients treated with at least one intravitreal dexamethasone implant for various retinal diseases: diabetic macular edema (265 eyes), central retinal vein occlusion (45 eyes), retinal vein branch occlusion (91 eyes), postoperative cystoid macular edema (18 eyes), non-infectious uveitis (37 eyes) and other (14 eyes) between July 2013 and April 2020 were reviewed.
Results
After 925 injections were applied to 470 eyes of a total of 383 patients, the eyes were controlled during a mean follow-up of 24 months. No complications were detected in 328 eyes. Intraocular pressure (IOP) above 25 mmHg was detected in 97 eyes (20.6%) that had no previous history of ocular hypertension. Of these 97 eyes, 71 (73.1%) eyes with increased IOP were treated with topical monotherapy, 26 (26.8%) eyes were treated with topical combined therapy and 1 (1.03%) patient had glaucoma surgery. Cataracts requiring surgical intervention developed in 55 (%21.73) of 253 phakic eyes. Three patients have anterior chamber dislocation of dexamethasone, 1 patient was hospitalized with sterile endophthalmitis on the 7th day after the injection, and pars plana vitrectomy was performed.
Conclusion
This study is the first long-term follow-up study in our country evaluating the safety of dexamethasone implant injections in various retinal diseases and presenting the first real world data. Cataract progression and increased IOP were found to be the most common side effects. We observed that the patient’s diagnosis did not cause a statistically significant change in the observation of side effects. As a result of our findings, close follow-up of IOP after the injection of dexamethasone implants would be appropriate.