Purpose: To describe effects of sustained-release steroid delivery devices on intraocular pressure (IOP) in eyes with glaucoma drainage devices (GDD).
Methods: Retrospective case series of eyes with steroid implants (dexamethasone or fluocinolone acetonide) and prior GDD (Ahmed, Baerveldt) without uveitis. Outcomes included IOP, IOP rise, central foveal thickness (CFT), and IOP medications.
Results: We included 14 eyes (14 patients, 38% male, 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 pre-implant, 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 medications was unchanged at month 3 (p = 1.0), and -0.36 medications at last follow-up (p = 0.35). Mean CFT change was -204 ± 158 μm (p = 0.001). There were no cases of endophthalmitis.
Conclusions: Intravitreal steroid implants were safe and effective for the treatment of post-surgical CME in patients with pre-existing GDD. There was no increase in IOP and no increase in antihypertensive drops.