Posters

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



Purpose:

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)

Setting:

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

Methods:

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.)

Results:

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.

Conclusions:

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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