Journal List > J Korean Ophthalmol Soc > v.56(5) > 1010273

Kim, Cho, Chung, and Heo: Intravitreal Injection of Dexamethasone Implant during Cataract Surgery in Patients with Noninfectious Uveitis



To investigate the efficacy and safety of intravitreal dexamethasone implant for controlling postoperative inflammation among uveitis patients undergoing cataract extraction.


Ten eyes with noninfectious uveitis underwent phacoemulsification with intraocular lens implantation followed by intravitreal injection of 0.7-mg dexamethasone implant (implant group) between February 2011 and January 2014. Twenty age- and gender-matched controls who received cataract surgery without implantation during the same period were recruited (non-im-plant group). Medical records of the subjects were retrospectively reviewed and 6-month postoperative clinical outcomes were compared between the 2 groups.


The mean age was 42.30  15.81 years in the implant group and 45.65  13.63 years in the non-implant group. The 2 groups were similar in terms of age, gender, preoperative inflammatory status, and preoperative visual acuity ( p = 0.552, 1.000, 0.133 and 0.767, respectively). After surgery, oral steroid was used in the non-implant group (8.8  1.5 mg/day on average) and the implant group (3.5  1.3 mg/day; p = 0.029). Visual acuity (log MAR) improved significantly in both groups ( p = 0.789) with no significant difference between the 2 groups. Postoperative recurrence rates of uveitis were reduced more (40%) in the implant group than in the non-implant group (50%) but without significance ( p = 0.709). Elevated intraocular pressure ≥25 mm Hg occurred in 3 eyes (30%) in the implant group and 4 eyes (20%) in the non-implant group ( p = 0.657), of which 1 in each group re-quired a filtering surgery. Otherwise, no significant complications developed in either group.


Intravitreal dexamethasone implants help reduce conventional oral steroid dosage for controlling postoperative inflammation. Dexamethasone implants could be an effective and safe alternative to control the inflammation after cataract surgery in uveitis patients.


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Figure 1.
Uveitis activity presented as anterior chamber cell grade before and after cataract surgery between 0.7 mg dex-amehasone implant and non-implant group. No significant differences are found at all points. A/C = anterior chamber; DEX = dexamethasone; POD = postoperative day.
Figure 2.
Systemic steroid dose before and after cataract surgery with independent-samples t-test. (A) Preoperative dose. (B) Postoperative dose. No significant differences are found before surgery ( p = 0.136). Significant differences are found after surgery ( p = 0.029).
Figure 3.
Consecutive changes of visual acuities (log MAR) after cataract surgery in patients with noninfectious uveitis. Visual acuities were improved significantly with Bonferroni correction in both groups. POD =postoperative day; DEX = dexamethasone. * p < 0.05 compared to baseline visual acuity of DEX-implant group; p < 0.05 compared to baseline visual acuity of Non-implant group.
Table 1.
Demographics and diagnosis of uveitis patients who underwent cataract extraction surgery
  0.7 mg DEX-implant group (n = 10) Non-implant group (n = 20) p-value
Age* 42.30 ± 15.81 45.65 ± 13.63 0.552
Sex (M:F) 6:4 12:8 1.000
  Behcet’s disease 5 13  
  Ankylosing spodylitis 0 1  
  Juvenile rheumatic arthritis 1 0  
  Idiopathic 4 6  

Values are presented as mean ± SD unless otherwise indicated.

DEX = dexamethasone.

* Independent-Samples t-test;

Fisher’s exact test.

Table 2.
Results of postoperative steroid injection in uveitis patients undergoing cataract surgery
Method Author (years) Patient number Mean age (years) F/U period (months) VA > 0.5 (%) IOP elevation (%)
IVTA Dada (2007) 20 34.95 6 70 25
IVTA Okhravi (2007) 19 54 3 89.5 16
Subtenon TA Paganelli (2004) 50 65 2 N/A 0
FA implant Chieh (2008) 24 46 12 55 40
IC dexamethasone Chang (2009) 91 67.4 1 N/A 4.7-16.7

F/U = follow up; VA = visual acuity; IOP = intraocular pressure; IVTA = intravitreal triamcinolone; TA = triamcinolone acetonide; N/A = not applicable; FA = fluocinolone acetonide; IC = intracameral.

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