Fluocinolone acetonide implant (FAci) one month after dexamethasone implant (DEXi) for chronic diabetic macular edema: 1-year results

Abstract

Purpose: To evaluate the safety and efficacy of FACi injected 1 month after the last DEXi injection in pseudophakic patients without ocular hypertension who required frequent DEXi injections (< 6 months).Patients and Methods: This was a prospective study including pseudophakic patients with chronic diabetic macular edema (DME) previously treated with DEXi without secondary ocular hypertension. All patients received DEXi followed by FAci one month later. Visits were scheduled at baseline, M1, then every 3 months up to 12 months.Results: 14 eyes of 11 patients were included and were followed until the 12-month time point. Visual gain was significant at M6 (+5.6 letters) and at M9 (+7.1 letters). A reduction in central macular thickness was obtained at 1 month (-86 µm), remaining stable over subsequent visits. The rate of ocular hypertension requiring pressure lowering treatment was 14%. Three eyes needed additional treatment (21%); one eye was treated with aflibercept, and 2 eyes with DEXi at M5 and M11. No patient underwant additional FAc implantation during the 11 months of follow-up.Conclusion: Injection of FAci one month after DEXi in pseudophakic patients with chronic DME who responded previously to DEXi results in anatomical improvement and deferred visual gain. This prospective study demonstrates the efficacy and safety of both implants in DME patients who have been previously treated with other therapies.