Safety and efficacy profile of the fluocinolone acetonide implant in non-infectious uveitic macular edema: 5-year follow-up.

Objective: To evaluate the safety and efficacy profile of the fluocinolone acetonide implant (FAI) in patients with non-infectious posterior segment uveitis over a 60-month follow-up period.

Methods: We retrospective conducted a study with a mean follow-up of 47 months (minimum, 18; maximum, 60). The study included 11 eyes (9 patients), with a male-to-female ratio of 8:1. The etiology of uveitis was heterogeneous. Efficacy parameters included visual acuity (VA) and Central macular thickness (CMT), and the ones who needed adjuvant therapy or re-injection. Safety parameters focused on the development of cataracts and intraocular hypertension.

Results: Real-world outcomes were assessed. Both VA recovery and CMT reduction were achieved between 3 to 6 months after FAI implantation and remained stable at the follow-up. All patients but one were pseudophakic prior to implantation. The phakic patient developed early cataract formation, requiring surgery 9 months post-implantation. All cases had previously received intravitreal dexamethasone. Five eyes (45.4%) required topical hypotensive therapy, and none glaucoma surgery. No patient required periodic adjuvant therapy or additional FAI injections, even among those with the longest follow-up periods. Two cases (18.1%) exhibited mild inflammatory activity in the macular area at months 33 and 35 post-implantation. These episodes were successfully resolved with sub-Tenon triamcinolone injections, maintaining clinical stability thereafter.

Conclusions: The fluocinolone acetonide implant (FAI), in our series of cases, turned out to be an effective and safe therapy for non-infectious uveitic macular edema, providing sustained and long-lasting effects, in some cases up to 60 months post-implantation. Sub-Tenon triamcinolone proves to be a valuable adjunctive therapy.