gms | German Medical Science

31. Internationaler Kongress der Deutschen Ophthalmochirurgen (DOC)

14.06. - 16.06.2018, Nürnberg

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A reversible surgical approach for treating eyes at risk of iatrogenic side effects with fluocinolone acetonide implants

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  • Ahmed Almarzooqi - Augenklinik, LMU, Munich
  • Siegfried Priglinger - Augenklinik, LMU, Munich
  • Armin Wolf - Augenklinik, LMU, Munich

31. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 14.-16.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocWK 3.10

doi: 10.3205/18doc091, urn:nbn:de:0183-18doc0919

Published: June 13, 2018

© 2018 Almarzooqi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Purpose: While proven to be an effective treatment for cystoid macular edema (CME), intravitreal steroid implants (IVSI) may cause undesirable side effects including steroid induced glaucoma or implant migration into the anterior chamber. The aim of this case series was to investigate the scleral-fixation of fluocinolone acetonide implants (ILUVIEN®) as a reversible approach in the treatment of chronic CME. We present a surgical method that allows easy implantation and explantation of Iluvien®-implants.

Methods: This case series enrolled 10 eyes that presented with disrupted anterior-posterior segment border and CME. All 10 eyes were treated with scleral fixation of Iluvien®-implants and were followed monthly according to protocol. Method of scleral fixation and removal of Iluvien®-implants will be presented.

Results: In all 10 eyes a significant reduction of CME was observed with a significant improvement of visual acuity (VA). None of the enrolled eyes experienced anterior migration of the implants. One eye experienced sustained increased intraocular pressure (IOP), where the implant was then removed using a “fishing-rod” approach.

Conclusions: Scleral fixation of Iluvien®-implants proves to be a reversible and safe approach allowing the easy removal of implants in case of iatrogenic side effects. It could be used in eyes vulnerable to side effects such as in cases of glaucoma.