OUTCOME OF FLUOCINOLONE ACETONIDE IMPLANT (RETISERT™) REIMPLANTATION FOR CHRONIC NONINFECTIOUS POSTERIOR UVEITIS

Abstract

In Brief Purpose: To evaluate outcomes of repeat intravitreal fluocinolone acetonide implant (Retisert™) in patients with chronic noninfectious posterior uveitis. Methods: Retrospective, observational case series of 10 eyes (10 patients) with recurrent noninfectious posterior uveitis who underwent a second fluocinolone acetonide implant in the same eye. Recurrence rate of ocular inflammation in the implanted eye was evaluated before and after the first and second implants. Surgical complications, visual acuity changes, need for adjunctive therapy, and safety were also assessed. Results: After first fluocinolone acetonide implantation, the visual acuity was stable or improved in 100% of patients and the median time to first recurrence was 32.5 months (range, 17.5–54 months). After second implantation, the median follow-up was 16.8 months, the visual acuity was stable or improved in 100% of patients, and four eyes had recurrences during the follow-up period (median, 18.3 months; range, 11–29.5 months). Kaplan-Meier estimate of time to recurrence following second implant was approximately 25 months to 30 months. All four phakic eyes underwent cataract extraction following the first implant and before the second implant. Five eyes required glaucoma surgery after the first implant and one eye after the second implant. Other complications included one case of vitreous hemorrhage after first implant and one rhegmatogenous retinal detachment at the site of second implant. Conclusions: Fluocinolone acetonide reimplantation for chronic noninfectious posterior uveitis offers similar control of ocular inflammation and complications profile as the first implantation. Fluocinolone acetonide implant (RetisertTM) appears to control inflammation, stabilize vision, and reduce the need for adjunctive therapy in patients with noninfectious posterior uveitis, whether used as primary implantation or following reimplantation. In 10 patients requiring reimplantation, the median time to recurrence was 32.5 months.