INJECTABLE FLUOCINOLONE IMPLANT FOR THE MANAGEMENT OF CHRONIC POSTSURGICAL CYSTOID MACULAR EDEMA IN VITRECTOMIZED EYES

Abstract

Purpose: Long-acting injectable steroids are changing the treatment paradigm for patients with chronic intraocular inflammation and cystoid macular edema (CME). We report the use of the fluocinolone implant 0.18 mg in patients with chronic postsurgical CME after pars plana vitrectomy. Methods: This is a retrospective case series of 24 vitrectomized eyes which received fluocinolone implant for the management postsurgical CME. Clinical outcomes and requirement for rescue therapy were studied. Results: Median length of follow-up was 19.3 months (range 8.3–23.2 months). There was an improvement in median central subfield thickness from 412 µm (range 167–806 µm) to 311 µm (range 157–686 µm) after fluocinolone implant (P < 0.001). The injection burden decreased significantly after study treatment (P < 0.001); however, there was no significant change in visual acuity (P = 0.334). Eighteen eyes had control of CME that did not require additional intravitreal therapy. Four eyes had initially controlled but recurrent CME requiring intravitreal steroid therapy at median of 7.8 months (range 7.6–15.4 months). One eye never attained sufficient inflammatory control despite rescue therapy. Conclusion: Fluocinolone implant can be an effective treatment in vitrectomized patients with chronic postsurgical CME and can help decrease the overall injection burden.