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See also comment(s) by Augusto Azuara Blanco •
OBJECTIVE: To report the incidence and management of elevated intraocular pressure (IOP) in patients with uveitis treated with the fluocinolone acetonide (FA) intravitreal implant. DESIGN: Pooled data from three multicenter, double-masked, randomized, controlled, phase 2b/3 clinical trials evaluating the safety and efficacy of the 0.59-mg or 2.1-mg FA intravitreal implant or standard therapy were analyzed. RESULTS: During the three-year follow-up, 71.0% of implanted eyes had an IOP increase of 10 mmHg or more than baseline and 55.1%, 24.7%, and 6.2% of eyes reached an IOP of 30 mmHg or more, 40 mmHg or more, and 50 mmHg or more, respectively. Topical IOP-lowering medication was administered in 74.8% of implanted eyes, and IOP-lowering surgeries, most of which were trabeculectomies (76.2%), were performed on 36.6% of implanted eyes. Intraocular pressure-lowering surgeries were considered a success (postoperative IOP of 6-21 mmHg with or without additional IOP-lowering medication) in 85.1% of eyes at one year. The rate of hypotony (IOP ≤ 5 mmHg) following IOP-lowering surgery (42.5%) was not different from that of implanted eyes not subjected to surgery (35.4%) (P = .09). CONCLUSION: Elevated IOP is a significant complication with the FA intravitreal implant but may be controlled with medication and surgery.
Dr. D.A. Goldstein, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1905 W Taylor St, M/C 648, Chicago, IL 60612, USA. debrgold@yahoo.com
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)