Fluocinolone Acetonide Intravitreal Implant 0.19 mg

How it works

The implant provides sustained low-dose intraocular delivery of fluocinolone acetonide, a glucocorticoid that suppresses inflammatory mediators, reduces vascular permeability and stabilises the blood-retinal barrier, decreasing macular oedema.

Prescribing in practice

• Sustained intraocular corticosteroid exposure commonly causes raised intraocular pressure and cataract progression, so steroid-induced glaucoma and lens changes must be monitored throughout the implant's lifespan.
• It is contraindicated in active or suspected ocular or periocular infection, including most viral, fungal and mycobacterial eye disease.
• Patient selection typically favours pseudophakic eyes or those already considered for cataract surgery, given the high likelihood of cataract formation.

Monitoring

Monitor intraocular pressure regularly and for prolonged periods after implantation, along with lens status and signs of infection, because steroid response can be delayed.

Counselling the patient

• Expect ongoing eye-pressure checks, as the steroid can raise pressure and may require additional drops.
• Development or worsening of cataract is likely over time and may eventually need surgery.
• Report any new eye pain, redness or visual changes promptly.

Evidence & guidelines

The FAME studies supported sustained-release fluocinolone acetonide implants for chronic diabetic macular oedema, and NICE has appraised this implant within defined patient groups.