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Sudhalkar, Aditya, MS*,†; Kodjikian, Laurent, MD, PhD; Chhablani, Jay, MS§; Bhojwani, Deepak, MS; Vasavada, Abhay, MS

doi: 10.1097/IAE.0000000000001883
Original Study

Purpose: To determine the association between the dexamethasone implant position in the vitreous cavity and ocular hypertension (OHT).

Methods: Retrospective review of patients with at least one intravitreal dexamethasone implant injection between 2012 and 2016. Patients who had a minimum follow-up for 6 months and documented evidence of the implant position were included in the study. Steroid responders, glaucoma patients, vitrectomized eyes, and eyes with liquefied vitreous were excluded. Relevant data were collected from patient charts. Three positions (P1, P2, and P3) were identified: P1 (in contact with the pars plana/ciliary body region), P2 (anterior to vortex veins), and P3 (posterior to vortex veins). Ocular hypertension was defined as absolute intraocular pressure > 25 mmHg and/or intraocular pressure rise > 10 mmHg. The relationship between implant position and intraocular pressure rise after factoring in other characteristics was the outcome measure. Appropriate statistical analysis was performed.

Results: A total of 377 patients (432 eyes; 257 males; 677 injections) were eligible for analysis. The median age was 57.24 (±6.32) years. Eighty-eight eyes had OHT. Of these, 54 eyes had the implant in P1. P1 was associated with high intraocular pressure response (>15 mmHg; P = 0.004) and early (<15 days) onset OHT (r = 0.84, P < 0.001).

Conclusion: Anterior position of dexamethasone implant in situ increases the risk of OHT.

The study looks at the association between the dexamethasone implant position in situ and the incidence of ocular hypertension when adjusted for other clinical characteristics that are known to be associated with intraocular pressure rise after injection.

*Sudhalkar Eye Hospital and Retina Centre, Baroda, India;

Raghudeep Eye Hospital, Ahmedabad, India;

Department of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civil de Lyon, University of Lyon, Lyon, France; and

§L. V. Prasad Eye Institute, Hyderabad, India.

Reprint requests: Aditya Sudhalkar, 22 Pratapgunj, Baroda 390002, Gujarat, India; e-mail:

L. Kodjikian has sat on advisory boards for Abbvie, Alcon, Allergan, Bayer, Krys, Novartis, Roche, and Théa; lecture fees from Alcon, Allergan, Bayer, Novartis, and Théa. The remaining authors have no financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.