Kevin Kennelly, David Keegan

Purpose:
The Geneva Study demonstrated the effi-cacy of intravitreal dexamethasone implants inmacular oedema secondary to retinal vein occlusions.We examined the safety and efficacy in an Irish cohort.

Method: A retrospective chart review.

Results: 20 Irish Caucasian patients were treated at amean of 69.5 years (range 59–86). 6 received multiple(n = 2–4) implants. Aetiologies were BRVO (50%),CRVO (40%), pseudophakic CMO (5%) and post-trabeculectomy hypotony maculopathy (5%). Mean duration of symptoms was 30 months (range 5–96).Mean follow-up was 14 months (range 3–25). 50%had preceding ocular pathology.Baseline VA was 50 ± 18 EDTRS letters. Rates of ?15letters gained were 22% at Day 30, 19% at Day 90,and 7% at Day 180. Rates of ?15 letters lost were 6%at Day 30, 13% at Day 90, and 7% at Day 180. Base-line central retinal thickness was 445 ± 152 ?m,decreasing by 86 ± 68 ?m at Day 90 and 3 ± 194 ?matDay 180.50% of phakic patients required cataract surgerywithin 2 years. 30% developed raised intraocular pres-sure (IOP), controlled topically in all cases. One patientwith an ACIOL developed corneal decompensation.For eyes receiving multiple implants, the mean inter-val was 7 months; 67% developed raised IOP; and80% of phakic eyes required cataract surgery.

Conclusion: We found inferior efficacy and increasedadverse events compared to the Geneva study, likelydue to broader inclusion criteria, longer duration ofsymptoms, off-label use and longer follow-up. Benefitswere temporary, requiring repeated injections.Adverse events were usually treatable. Implantsshould be contraindicated in patients with ACIOLs.