Post-cataract Outcomes in Patients with Noninfectious Posterior Uveitis Treated with the Fluocinolone Acetonide Intravitreal Implant

Overview

Journal Clin Ophthalmol

Publisher Dove Medical Press

Specialty Ophthalmology

Date 2012 Jan 26

PMID 22275811

Citations 7

Authors

John D Sheppard Jr

Quan Dong Nguyen

Dale W Usner

Timothy L Comstock

Affiliations

Soon will be listed here.

Abstract

Purpose: To describe visual acuity (VA) and inflammation following cataract surgery in eyes with noninfectious posterior uveitis (NIPU) that were being treated with a fluocinolone acetonide (FA) intravitreal implant compared with those that were not.

Design: Post hoc, subgroup analysis of data from a 3-year, dose-masked, randomized, multicenter trial evaluating the FA implant for the treatment of NIPU.

Participants And Controls: The subset of eyes that underwent cataract surgery during the 3-year trial. Eyes were either implanted with a 0.59- or a 2.1-mg FA implant, or, in the case of affected fellow eyes, received standard-of-care local treatment.

Main Outcome Measures: VA, anterior and posterior chamber inflammation at 1 and 3 months after surgery, and rate of uveitis recurrence and serious postoperative ocular adverse events.

Results: Of 278 patients enrolled in the main trial, 132/142 phakic implanted eyes and 39/186 phakic non-implanted eyes underwent cataract surgery. Mean improvement in VA was significantly greater in implanted than non-implanted eyes at 1 (P = 0.0047) and 3 months (P = 0.0015) postoperatively; significantly fewer anterior chamber cells were seen in implanted than non-implanted eyes at 1 (P = 0.0084) and 3 months (P = 0.0002). Severity of vitreous haze was less in implanted than non-implanted eyes at 3 months postoperatively (P = 0.0005). The postsurgical uveitis recurrence rate was lower in implanted than non-implanted eyes (26.5% vs 44.4%; P = 0.0433). Glaucoma was reported in 19.7% of implanted eyes and no non-implanted eyes (P = 0.0008) postoperatively.

Conclusion: In this post hoc subgroup analysis, eyes with NIPU treated with the FA intravitreal implant demonstrated better vision and less intraocular inflammation following cataract surgery than non-implanted eyes. Recurrent uveitic inflammation did not appear to be triggered by cataract surgery. Glaucoma occurred more frequently in implanted eyes.

Citing Articles

Corticosteroid implants for chronic non-infectious uveitis.

Reddy A, Liu S, Brady C, Sieving P, Palestine A Cochrane Database Syst Rev. 2023; 8:CD010469.

PMID: 37642198 PMC: 10464657. DOI: 10.1002/14651858.CD010469.pub4.

Corticosteroid implants for chronic non-infectious uveitis.

Reddy A, Liu S, Brady C, Sieving P, Palestine A Cochrane Database Syst Rev. 2023; 1:CD010469.

PMID: 36645716 PMC: 9841887. DOI: 10.1002/14651858.CD010469.pub3.

Therapeutic potential of pupilloplasty combined with phacomulsification and intraocular lens implantation against uveitis-induced cataract.

Lu H, Chen D, Zhu S Int J Ophthalmol. 2022; 15(10):1598-1603.

PMID: 36262864 PMC: 9522572. DOI: 10.18240/ijo.2022.10.06.

Long-term results of cataract surgery in patients with anterior uveitis.

Balta O, Sungur G, Acar M, Kosker M, Yakin M, Ornek F Int Ophthalmol. 2017; 38(4):1399-1407.

PMID: 28602016 DOI: 10.1007/s10792-017-0598-z.

Corticosteroid implants for chronic non-infectious uveitis.

Brady C, Villanti A, Law H, Rahimy E, Reddy R, Sieving P Cochrane Database Syst Rev. 2016; 2:CD010469.

PMID: 26866343 PMC: 5038923. DOI: 10.1002/14651858.CD010469.pub2.

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