INTRAVITREAL SUSTAINED RELEASE STEROID IMPLANTS ARE SAFE AND EFFECTIVE IN PATIENTS WITH GLAUCOMA DRAINAGE DEVICES

To describe effects of sustained-release steroid delivery devices on intraocular pressure (IOP) in eyes with glaucoma drainage devices.

Retrospective case series of eyes with steroid implants (dexamethasone or fluocinolone acetonide) and prior glaucoma drainage devices (Ahmed, Baerveldt) without uveitis. Outcomes included IOP, IOP rise, central foveal thickness, and IOP medications.

We included 14 eyes (14 patients, 38% men, 94% pseudophakic). Mean age at steroid implantation was 64 ± 12 years. Baerveldt (64%) was more common than Ahmed (36%). Tubes were in the anterior chamber (57.1%), sulcus (28.6%), and pars plana (14.3%). Ozurdex (93%) was more common than Yutiq (7%). Mean IOP was 13.5 ± 3.4 mmHg preimplant, 11.8 ± 3.7 mmHg at month 1, 13.3 ± 3.6 mmHg at month 3 ( P = 0.35), and 11.3 ± 3.8 mmHg at 1 year ( P = 0.032). Mean antihypertensive medication was unchanged at month 3 ( P = 1.0) and -0.36 medication at last follow-up ( P = 0.35). Mean central foveal thickness change was -204 ± 158 µ m ( P = 0.001). There were no cases of endophthalmitis.

Intravitreal steroid implants were safe and effective for the treatment of postsurgical CME in patients with pre-existing glaucoma drainage devices. There was no increase in IOP and no increase in antihypertensive drops.