Intravitreal dexamethasone implant injections, such as Ozurdex (Allergan), have earned a favorable safety endorsement in a recent study published in the British Journal of Ophthalmology. The largest-of-its-kind study shows complications associated with the device when used to treat various retinal conditions are rare and, when they do occur, easily manageable.

The study looked at 6,015 injections in 2,736 eyes of 1,441 patients over an average of 18 months. Cataract progression and intraocular pressure (IOP) rise were the most commonly noted side effects with 576 eyes (32.5% of the phakic eyes) that developed cataracts requiring surgery. Visually insignificant cataracts that did not require surgery were observed in another 259 phakic eyes.

Of the eyes studied, 727 (26.5%) experienced an IOP rise of >25mm Hg, 5.67% of which had a prior history of glaucoma. More than 90% of those eyes were managed medically, and 0.5% eyes required filtering surgery.

Other complications, such as endophthalmitis (0.07%), retinal detachment (0.03%) and vitreous hemorrhage (0.03%), were even more rare. No significant visual acuity changes or central macular thicknesses were noted.

Intravitreal dexamethasone implant injections are used for patients with central retinal venous occlusion, diabetic macular edema, post-surgical cystoid macular edema and uveitis.

Rajesh B, Zarranz-Ventura J, Fung A, et al. Safety of 6000 intravitreal dexamethasone implants. Br J Ophthalmol. April 30, 2019. [Epub ahead of print].