Pars plana suturing of intravitreal fluocinolone acetonide in noninfectious uveitis.

Abstract

Purpose: To described and evaluate a technique in which the fluocinolone acetonide 0.18 mg implant is sutured into the pars plana in cases of noninfectious uveitis.

Methods: Ocular vitals and slit lamp examination was performed at baseline, 1 month, 3 months, 6 months and 12 months follow up. Optical coherence tomography was obtained at all these visits. Data assessed included visual acuity; intraocular pressure; signs of active inflammation including anterior chamber cell, anterior chamber flare, vitreous cell, macular edema, as well as other forms of ocular inflammation; surgical complications; and need for additional interventions.

Results: 6 eyes of 6 patients had scleral fixation of the fluocinolone implant. The mean visual acuity remained stable between the visit prior to refixation and 12 months after scleral fixation (0.03 log MAR change, p = 0.92). The mean macular central subfield thickness decreased from the visit prior to refixation to 12 months after scleral fixation (252.4 μm decrease, p = 0.38). No eyes required additional therapy to control posterior noninfectious uveitis or macular edema.

Conclusion: In patients with aphakia, compromised zonules/posterior lens capsule, and anterior or scleral-fixated intraocular lenses, all of which are contraindications to injection of posterior segment implants, scleral fixation of the 0.18 mg fluocinolone acetonide implant may be useful for treatment of noninfectious uveitis.