Management of Sympathetic Ophthalmia with the Fluocinolone Acetonide Implant

Objective: We examined whether implantation of the fluocinolone acetonide (Retisert) implant achieved control of inflammation and a reduced need for oral corticosteroids or immunosuppressives in patients with sympathetic ophthalmia (SO). Design: Retrospective, noncomparative case series. Participants: Eight patients with active SO. Methods: The results of fluocinolone acetonide implantation in 8 patients with active SO were studied with a follow-up period of 6 months to 2 years. Main Outcome Measures: Presence or absence of intraocular inflammation, visual acuity, intraocular pressure, need for further surgery, and the need for additional use of oral or locally injected corticosteroids and/or immunosuppressives. Results: All patients demonstrated a significant reduction in the systemic medication required to maintain control of inflammation. Two patients had recurrent inflammatory episodes requiring the resumption of an oral immunosuppressive. Vision improved or was stabilized in all 8 patients. Conclusions: The fluocinolone acetonide implant provides inflammatory control and reduces the dependence on systemic immunosuppression in patients with SO. Financial Disclosure(s): The authors have no commercial or proprietary interests in any material discussed in this article. Ophthalmology 2009;116:552-557 (C) 2009 by the American Academy of Ophthalmology.