The eye works like a camera. It has two parts, a lens and a film. The film layer lines the back wall of the eyes and is called the retina. There is a transparent gel which is located in front of the retina called the vitreous. The retina has arteries that provide it blood flow and veins which drain the blood. Diabetic changes are characterized by abnormally leaky blood vessels. This may allow fluid to accumulate in the retina and decrease the quality of vision. Fortunately, this condition is very treatable.
Iluvien is a tiny non-biodegradable implant which is injected into the vitreous cavity. It provides the eye with a continuous low dose of steroid medication over a 36-month period and may be re-injected every 36 months, if needed.
Iluvien is highly effective at improving vision and lowering the risk of vision loss from diabetic macular edema. It typically decreases the number of patient visits and future intravitreal injections.
Some patients may not need any additional treatment during the 36 months in which Iluvien is effective. However, many patients will continue to need occasional (but less frequent) injections of other medications such as Avastin, Lucentis, Eylea, or Ozurdex.
Retina specialists are not able to accurately predict how many injections a patient will need. They will tailor therapy based on the results following treatment.
Iluvien is a corticosteroid. All corticosteroids increase the risk of developing cataracts or high eye pressure. Eighty percent of all patients who have not had cataract surgery will require cataract surgery within 3 years of receiving Iluvien. Cataract surgery is a painless, safe, and effective outpatient surgery which quickly restores vision for those with cataracts.
Approximately 40% of patients receiving Iluvien will develop elevated eye pressure. This is almost always easily treated with eye drops. The risk of requiring glaucoma surgery to lower eye pressure is very low (5 percent or less).
Patients who have already received an intravitreal steroid injection and did not have a significant intraocular pressure elevation may be candidates for Iluvien.
Iluvien is injected utilizing a similar technique as other intravitreal injections. However, most patients will feel significantly more pressure during the injection than with other treatments.
Retina specialists will continue to follow patients closely after an injection of Iluvien. The time between visits will be carefully determined based on the eye’s response to Iluvien.