Intravitreal Fluocinolone Acetonide (ILUVIEN) Implant for the Treatment of Refractory Cystoid Macular Oedema After Retinal Detachment Repair

Abstract

Cystoid macular oedema (CMO) is one of the most frequent postoperative macular complications to cause partial visual recovery aftersuccessful retinal detachment (RD) repair. Refractory CMO is difficult to treat and many strategies have been employed with varyingdegrees of success. We report for the first time the use of ILUVIEN implant to treat refractory CMO after successful RD repair. A 65-yearoldfemale presented with right eye full-thickness macular hole and underwent pars plana vitrectomy, internal limiting membranepeeling and cryotherapy with gas tamponade with 12% C3F8. She subsequently developed right eye macula-on RD and proliferativevitreoretinopathy and required multiple procedures for successful retinal reattachment. Later, she developed CMO that responded tointravitreal triamcinolone injections and intravitreal dexamethasone 0.7-mg implants but recurrence of CMO continued to be a problem.After receiving ILUVIEN intravitreal implant, her visual acuity improved and CMO resolved without recurrence for 13 months.Refractory CMO after RD repair is difficult to treat and in a quarter of cases will not improve without treatment. Our case shows thata single ILUVIEN implant maintained anatomical dry fovea and improved vision. This also demonstrates that ILUVIEN is an effectivemanagement strategy to reduce the need for repeated treatments.