Dexamethasone Intravitreal Implant in the Treatment of Uveitic Macular Edema in the Peri-operative Cataract Setting: A Case Series

• Published in: American journal of ophthalmology
• Main Authors: Larochelle, Marissa Bucci, Smith, Jesse, Dacey, Mark S
• Format: Journal Article
• Language: English
• Published: 2015
• Subjects: Ophthalmology
• ISSN: 0002-9394
• DOI: 10.1016/j.ajo.2016.03.049

Purpose To examine the efficacy of the dexamethasone (DEX) intravitreal implant (Ozurdex; Allergan, Inc., Irvine, CA) in the control of uveitic macular edema in the perioperative setting of cataract surgery. Design Retrospective observational case series. Methods Setting: Clinical practice. Participants A total of 17 eyes of 14 patients that received a DEX implant for macular edema (CME) associated with noninfectious uveitis who underwent subsequent phacoemulsification within 4 months. Each patient was treated with a DEX 0.7 mg intravitreal implant and underwent phacoemulsification with intraocular lens placement. Primary outcome measure was the change in central macular thickness (CMT) measured by optical coherence tomography (OCT) measured preoperatively and postoperatively. Results Seventeen eyes (14 patients) were included for analysis. There was no statistically significant change from preoperative CMT (mean 302 μm) to postoperative CMT (307 μm) on OCT. In the subset of eyes that underwent phacoemulsification within four weeks of the DEX implant (8 eyes), the mean change in CMT was -47.0 μm, compared to +51.1 μm in those that received the DEX implant greater than 4 weeks prior to phacoemulsification (P = 0.005). Conclusions Intravitreal dexamethasone implant was shown to prevent the recurrence or worsening of macular edema in uveitic patients with a history of CME who underwent phacoemulsification. The mean CMT decreased in the subset of eyes that received the DEX implant within 4 weeks prior to cataract surgery.