Name of the Procedure:

Injection, Fluocinolone Acetonide, Intravitreal Implant (Iluvien)
Common Name: Iluvien Injection
Technical Term: Intravitreal Implant of Fluocinolone Acetonide

Summary

The Iluvien injection involves implanting a small device that releases a corticosteroid called fluocinolone acetonide directly into the eye. This procedure is typically performed to treat chronic eye conditions and aims to reduce inflammation and improve vision over time.

Purpose

The Iluvien injection is designed to treat chronic diabetic macular edema (DME), a condition where fluid accumulates in the macula, causing vision impairment. The implant continuously releases medication to reduce inflammation, thereby helping to preserve or improve vision.

Indications

• Persistent diabetic macular edema (DME) not adequately responding to other treatments
• Swelling in the retina due to diabetes

Criteria:

• Patients with chronic DME
• Patients who have tried other treatments without sufficient improvement

Preparation

• No specific fasting required.
• Continue taking prescribed medications, unless advised otherwise by your doctor.
• Pre-procedure eye examination to assess the condition.
• Pupils may be dilated with eye drops for the examination.

Procedure Description

1. The patient will be seated or lying down.
2. Anesthetic eye drops will be administered to numb the eye.
3. The area around the eye will be cleaned.
4. A small device containing fluocinolone acetonide will be injected into the vitreous humor (the gel-like substance in the eye) using a fine needle.
5. The entire process is typically painless due to the anesthetic.

Tools: Injection device loaded with fluocinolone acetonide, antiseptic solution, anesthetic eye drops.
Anesthesia: Local anesthesia (eye drops).

Duration

The procedure typically takes about 15-30 minutes.

Setting

This procedure is usually conducted in an outpatient clinic or hospital setting, where sterile conditions can be maintained.

Personnel

• Ophthalmologist or retina specialist
• Assisting nurse or medical technician

Risks and Complications

Common Risks:

• Temporary discomfort or redness in the eye
• Increased eye pressure

Rare Risks:

• Infection (endophthalmitis)
• Cataract formation
• Detached retina

Benefits

• Continuous release of medication for up to 36 months
• Reduction in inflammation and swelling
• Improved and stabilized vision over time

Recovery

• Avoid strenuous activities for a few days
• Follow-up appointments to monitor eye pressure and healing
• Use prescribed eye drops to prevent infection
• Some patients may experience temporary blurred vision or discomfort

Alternatives

• Anti-VEGF (vascular endothelial growth factor) injections, which need to be administered more frequently
• Laser treatment; however, it may not be as effective for chronic cases
• Oral or topical corticosteroids, but with a higher risk of systemic side effects

Patient Experience

During the Procedure:

• Minimal to no pain due to local anesthesia
• Slight pressure sensation as the injection is administered

After the Procedure:

• Mild discomfort or sensation of a foreign body in the eye
• Vision might be temporarily blurred
• Over-the-counter pain relievers can be used to manage any discomfort