Abstracto

Real-world evaluation of postoperative in-office Dexamethasone intracanalicular insert administration for control of postoperative inflammation following cataract surgery

P Dee G Stephenson

Background: The purpose of this study is to describe outcomes with in-office postoperative use of the dexamethasone intracanalicular insert for control of postoperative inflammation following cataract surgery when administered in the office on the first postoperative day.

Methods: Data from consecutive patients undergoing uncomplicated femtosecond-assisted phacoemulsification were retrospectively drawn from electronic health records. All eyes received in-office placement of a single dexamethasone insert into the inferior punctum of the operative eye on the first postoperative day. Pain was graded as none/mild/moderate/severe and anterior chamber cells and flare were graded using the Standardization of Uveitis Nomenclature Working Group’s standardized schema preoperatively and 1 day, 1-2 weeks, and 6-8 weeks postoperatively. Intraocular pressure (IOP) data, as well as adverse events, were also recorded at all time points.

Results: Overall, data from 17 eyes of 12 patients were included in this analysis. All eyes had modest amounts of cells and flare in the anterior chamber on the first postoperative day before dexamethasone insert placement. By the week 1-2 visit (mean 12 days postoperatively) and again at the week 6-8 visit (mean 51 days postoperatively), no eyes had any cells or flare (0%). The insert was visualized in all eyes at week 1-2 and had dissolved completely in 16/17 eyes (94.1%) by week 6-8. No clinically significant IOP elevations occurred in any eyes and mean IOP was significantly reduced throughout follow-up.

Conclusions: Real-world experience with the dexamethasone intracanalicular insert placed in-office on the first postoperative day following cataract surgery is consistent with findings from previous clinical trials and demonstrated that the therapy safely and effectively controlled postoperative inflammation in combination with topical NSAID therapy. This product offers surgeons the opportunity to optimize adherence with anti-inflammatory therapy, while reducing patients’ postoperative topical therapy burden, after cataract surgery.