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Intraocular Pressure in Patients With Uveitis Treated With Fluocinolone Acetonide Implants
Debra A. Goldstein, MD, FRCSC;
David G. Godfrey, MD;
Anthony Hall, MD;
David G. Callanan, MD;
Glenn J. Jaffe, MD;
P. Andrew Pearson, MD;
Dale W. Usner, PhD;
Timothy L. Comstock, OD
Arch Ophthalmol. 2007;125:(doi:10.1001/archopht.125.11.ecs70063).
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 3 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 3-year follow-up, 71.0% of implanted eyes had an IOP increase of 10 mm Hg or more than baseline and 55.1%, 24.7%, and 6.2% of eyes reached an IOP of 30 mm Hg or more, 40 mm Hg or more, and 50 mm Hg 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 mm Hg with or without additional IOP-lowering medication) in 85.1% of eyes at 1 year. The rate of hypotony (IOP  5 mm Hg) 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.
Author Affiliations: Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago (Dr Goldstein); Glaucoma Associates of Texas (Dr Godfrey) and University of Texas Southwestern Medical School (Drs Godfrey and Callanan), Dallas, and Texas Retina Associates, Arlington (Dr Callanan); The Royal Melbourne Hospital, Victoria, Australia (Dr Hall); Duke University Eye Center, Durham, North Carolina (Dr Jaffe); Department of Ophthalmology and Visual Science, University of Kentucky, Lexington (Dr Pearson); and Bausch & Lomb, Rochester, NY (Drs Usner and Comstock).
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