Long-term results of fluocinolone acetonide intravitreal implant in Behçet intractable posterior uveitis.

OBJECTIVE

To evaluate the long-term efficacy and safety of the fluocinolone acetonide intravitreal implant in patients with Behçet disease with intractable noninfectious posterior uveitis.

DESIGN

Consecutive retrospective analysis.

PARTICIPANTS

Eight eyes from 7 patients with Behçet uveitis who did not respond successfully to conventional treatment with topical and systemic steroids and/or systemic steroid-sparing agents were studied.

METHODS

We performed a chart review of patients who were treated with a 0.59-mg fluocinolone acetonide intravitreal implant at a single centre from September 2007 through June 2009. Snellen visual acuity, control of inflammation, and the development of complications such as infection or uncontrollable intraocular pressure (IOP) elevation were evaluated.

RESULTS

Mean age at implant placement was 35.3 (range 17-42) years. Mean follow-up duration was 47.8 (range 39.5-57.6) months. Postoperative visual acuity improved by more than 3 lines in 6 eyes (75%). Five patients were able to discontinue all systemic medications. Six eyes (75%) exhibited postoperative IOP spikes of more than 30 mm Hg. Five patients required glaucoma shunting surgery postoperatively for IOP control. The single phakic eye developed a visually significant posterior subcapsular lens opacification that required cataract extraction. There was 1 case of postoperative cytomegalovirus endothelitis. Infection was controlled with oral valganciclovir and topical antibiotic medication, and the patient did not require implant removal.

CONCLUSIONS

The fluocinolone implant is effective in the control of intractable inflammation in Behçet uveitis. Elevation of IOP remains a major potential complication, and the possibility of infection should be considered.