title: Evaluation of the safety and performance of an applicator for a novel intravitreal dexamethasone drug delivery system for the treatment of macular edema.
abstract: OBJECTIVE
  Evaluation of safety and performance of an applicator-inserted dexamethasone drug delivery system.
  
  
  METHODS
  Patients with clinically observable macular edema were randomized to receive 700 microg dexamethasone drug delivery system via a pars plana incisional placement (n = 10) or a 22-gauge applicator insertion (n = 20). Outcome measures included assessment of procedure duration, the postinsertion wound, adverse events, intraocular pressure, and best-corrected visual acuity at baseline and days 1, 7, 14, 30, 60, 90, and 180.
  
  
  RESULTS
  Both procedures were well tolerated and none of the patients in the applicator group required sutures to close the insertion wound. The overall incidence of ocular adverse events was less in the applicator group (13/19; 68.4%) than the incisional group (9/10; 90%), although the difference was not statistically significant in this pilot study. Vitreous hemorrhage occurred in two patients in the incisional group and none in the applicator group. Increases in intraocular pressure were less frequent in the applicator group (3/19; 15.8%) than the incisional group (3/10; 30%). No cases of endophthalmitis or retinal detachment occurred in either group. The percentage of patients achieving improvement in visual acuity of >/=15-letters at Day 90 was similar in both groups; 40% (8/20) in the applicator group and 30% (3/10) in the incisional group.
  
  
  CONCLUSIONS
  The dexamethasone drug delivery system applicator system performed well, allowing safe, effective, and sutureless intravitreal placement of 700 microg dexamethasone drug delivery system.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA. jhaller@willseye.org
authors.forename: Julia A
authors.initials: JA
authors.lastname: Haller
authors.forename: Pravin
authors.initials: P
authors.lastname: Dugel
authors.forename: David V
authors.initials: DV
authors.lastname: Weinberg
authors.forename: Connie
authors.initials: C
authors.lastname: Chou
authors.forename: Scott M
authors.initials: SM
authors.lastname: Whitcup
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D016503:Drug Delivery Systems / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007429:Intraocular Pressure; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity; D014822:Vitreous Body; D014945:Wound Healing
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone