Single-centre audit assessing the safety profile and efficacy of combined BMICS (Bimanual micro-incision cataract surgery) and Iluvien® (fluocinolone acetonide) in chronic diabetic macular oedema (DMO) insufficiently responsive to other therapies

Poster Details

First Author: S.Lee UK

Co Author(s):    A. Yousif   S. Shafquat                          

Abstract Details


To assess the safety profile and early efficacy of combined BMICS and Iluvien® implants in patients with DMO. We also compared the safety profile with other real world data (IRISS study)


Retrospective observational study at Russell's Hall Hospital, a general district hospital in Birmingham, UK


Patients were identified from the theatre register. All patients included had chronic DMO, had significant lens opacities and were insufficiently responsive to intravitreal injections of anti-VEGF and/or laser. A single surgeon carried out all procedures. Efficacy of Iluvien® was assessed from changes in central macular thickness (CMT) from baseline using OCT and vision assessment. Any complications were recorded (IOP raise, inflammation, endophthalmitis.)


5 eyes from 5 patients had been followed up for a mean duration of 144 days (range 14-347) following combined BMICS and Iluvien® implant. The mean age of our cohort of patients was 73 with a mean duration of DMO lasting 16.4 months (range 12-24). All patients had prior treatment for DMO (100% Lucentis (average 8) and 3 (60%) have had previous focal/grid/PRP laser). 2 patients (40%) required to go back to intravitreal Lucentis injections due to worsening of DMO. When treated with Iluvien® the mean reduction in CMT was 52.6 µm (from average baseline of 374.2 µm). At 3 months, the average numbers of letters gained was 9.6 letters and only 1 patient (20%) required temporary IOP lowering therapy. Following the combined procedure 4 patients (80%) was within 1D of their aimed spherical equivalence using the IOL master. No cases of endophthalmitis or uveitis were reported.


With an average of 4 months follow-up after treatment with combined BMICS and Iluvien® there was an improvement in CMT and improvement in the average number of letters read by the patients. The incidence of raised IOP (20%) is similar to the IRISS study. No significant morbidities were noted and 80% of the patients achieved within 1D of their aimed refractive outcome using the IOL master. Our results demonstrated the early effects of combined BMICS and intravitreal Iluvien® implant. This combined procedure is an effective and safe option for patients with chronic DMO refractory to anti-VEGF or laser treatment.

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