Reimplantation of a Fluocinolone Acetonide utained Drug Delivery Implant for Chronic Uveiti Original Reearch Article

Purpoe To determine the effect of a econd fluocinolone implant inerted in eye with uveiti in which recurrent inflammation developed after the original implant wa placed. Deign Propective, interventional trial. Method tudy ubject compried all conecutive patient with noninfectiou poterior uveiti who were treated at the Duke Eye Center from March 2004 to July 2007, and followed for at leat nine month, in whom a fluocinolone acetonide implant wa initially inerted, and in whom the implant wa replaced, or a econd implant wa inerted becaue of recurrent inflammation. The main outcome meaure were inflammation recurrence, ue of adjunctive anti-inflammatory therapy, viual acuity, intraocular preure (IOP), and advere event. Reult eventeen eye of 14 patient were tudied. The mean time from original fluocinolone implantation to firt uveiti recurrence wa 38 month. The time from firt inflammation recurrence to the econd implantation wa eight month. The average follow-up wa 17 month. Inflammation developed in only one eye during follow-up, three year after the econd fluocinolone implant inertion. Adjunctive teroid ue wa decreaed ignificantly. The mean nellen viual acuity 12 month after the econd implant inertion wa 20/78, compared with 20/400 at the time of the original fluocinolone implant placement (P = .04). The average IOP wa unchanged after urgery compared with the preoperative IOP. Concluion The fluocinolone implant control ocular inflammation for an average of three year after initial inertion. After the implant i depleted of drug, inflammation may recur. Placement of a new implant maintain the eye in a quiet tate and tabilize or improve viual acuity for an extended time. Advere event during inertion of a new implant are uncommon.