Immediate Intraocular Pressure Changes Following Intravitreal Dexamethasone Implant

To evaluate the immediate intraocular pressure (IOP) changes following intravitreal dexamethasone implantation.

Thirty-four eyes of 34 consecutive patients (16 females and 18 males; mean age, 59.9 ± 9.0 years) with diagnosis of macular edema secondary to diabetic retinopathy (20 eyes) or retinal vein occlusion (14 eyes) scheduled for intravitreal dexamethasone implantation (Ozurdex) were included in the study. IOP at baseline, minute 1, minute 10, hour 1, and day 1 was measured using Tono-Pen XL. As a subgroup, the eyes with visible reflux after the implantation were analyzed separately for IOP change.

Overall, the only significant change in relation to baseline was observed immediately after the implantation (16.5 ± 3.4 mmHg at baseline vs. 13.5 ± 5.7 mmHg at minute 1, P = 0.004). In eyes with reflux (N = 9), the mean IOP was 15.4 ± 2.4, 6.3 ± 4.2, 10.1 ± 4.4, 15.8 ± 2.9, and 15.6 ± 2.2 mmHg at baseline, minute 1, minute 10, hour 1, and day 1, respectively. The mean IOP was significantly lower at minute 1 (P = 0.008) and minute 10 (P = 0.013). In eyes without reflux (N = 25), the mean IOP was not significantly altered at any time point (for all P > 0.05). The rate of hypotony (IOP <6 mmHg) at minute 1, minute 10, hour 1, and day 1 was 8.8%, 2.9%, 0%, and 0%, respectively. Wound leakage and choroidal detachment were not observed in any of the eyes.

The injection procedure of the Ozurdex implant itself does not affect IOP, except in the case of observable reflux, in which case the IOP temporarily decreases.