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

Abstract

To examine the efficacy of the dexamethasone (DEX) intravitreal implant (Ozurdex; Allergan, Inc, Irvine, California, USA) in the control of uveitic macular edema in the perioperative setting of cataract surgery. Retrospective observational case series. setting: Clinical practice. A total of 17 eyes of 14 patients that received a DEX implant for cystoids macular edema (CME) associated with noninfectious uveitis who underwent subsequent phacoemulsification within 4months. Each patient was treated with a DEX 0.7mg 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. Seventeen eyes (14 patients) were included for analysis. There was no statistically significant change from preoperative CMT (mean 302μm) to postoperative CMT (307μm) on OCT. In the subset of eyes that underwent phacoemulsification within 4weeks of the DEX implant (8 eyes), the mean change in CMT was-47.0μm, compared to+51.1μm in those that received the DEX implant greater than 4weeks prior to phacoemulsification (P= .005). 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 4weeks prior to cataract surgery.