Purpose: To report adverse events after treatment of macular edema secondary to retinal vein occlusion with intravitreal dexamethasone implant (IDI) in a UK center across three treatment rounds.
Methods: A review of 61 eyes receiving IDI treatment (1 implant [n = 61], 2 implants [n = 17], 3 implants [n = 6]). Data were collected at initiation and 2 and 6 months. Outcomes were intraocular pressure (IOP) (mean IOP, IOP >25 mmHg and IOP rise >10 mmHg) and cataract surgery. Other adverse events were recorded as they occurred. An adverse event incidence in central retinal vein occlusion versus branch retinal vein occlusion and glaucoma/ocular hypertension versus nonglaucoma/ocular hypertension subgroups was analyzed.
Results: Ten eyes (12%) had IOP >25 mmHg, whereas 11% required medical and 1.2% required surgical IOP management. No significant IOP change was observed during the second/third implant rounds. The IOP was higher in the glaucoma/ocular hypertension and central retinal vein occlusion subgroups. Twenty-four percent of treated phakic eyes required cataract surgery, and the incidence increased with repeated implants. The mean time to cataract surgery from IDI initiation was 377 days.
Conclusion: Intraocular pressure rise is greatest 2 months after implant. In the absence of IOP complications after initial IDI exposure, repeated treatments do not represent an increased IOP risk profile. Central retinal vein occlusion and glaucoma/ocular hypertension subgroups are more likely to experience IOP-related side effects. The incidence of cataract surgery significantly increases with repeated IDI treatments.