Real-world experience with dexamethasone intraocular suspension in cataract surgery

Mitchell A. Jackson, MD, presents details of a retrospective review of dexamethasone intraocular suspension 9%, including reduced postoperative inflammation.

Reviewed by Mitchell A. Jackson, MD

A retrospective trial of dexamethasone intraocular suspension 9% (Dexycu, EyePoint Pharmaceuticals) showed favorable early experiences during cataract surgery, according to Mitchell A. Jackson, MD.

Jackson, who is the founder and CEO of Jacksoneye, Lake Villa, Illinois, presented results of the study during the ASCRS 2021 annual meeting in Las Vegas, Nevada, including early real-world outcomes in a cohort of patients who underwent cataract surgery that included administration of dexamethasone intraocular suspension 9% at the end of the procedure.

Patients who underwent surgery from March 12, 2019, to December 15, 2019, were included in this retrospective multicenter analysis.

When possible, the study analyzed data on anterior chamber cell (ACC), anterior chamber flare (ACF), and intraocular pressure (IOP) on postoperative days 1, 8, 14, and 30.

A total of 527 patients (641 eyes; 58.4% female) were included, about three-quarters of whom were Caucasian. Of the total number of patients, 28 (37 eyes) were Jackson’s patients.


Results

By postoperative day 8, about 65% of patients had grade 0 anterior chamber cells, and on postoperative day 30 that percentage increased to 90%. In his hands, the respective percentages were about 49% and 91%.

The ACF data showed that on postoperative days 8 and 30, the respective percentages for all patients and for Jackson’s patients were about 92% and 98%.

Regarding visual acuity (VA), he reported that the target best-corrected VA of 20/25 or better was achieved in 97% of eyes.

Analysis of the IOP data indicated that the drug was well-tolerated in all study eyes, with the IOP on day 30 15 mmHg.


Recommended administration technique

Jackson advised administering the drug as the final step of the surgery.

“Intracapsular administration enables better visualization of the drug volume and more reliable drug placement,” he said.

His pearls for administration are the following: ensure that incisions are well-sealed and the AC is deep, pressurize the eye close to the desired postoperative IOP, and maintain wound stability by minimizing manipulation and rehydrating gently as needed.

Jackson pointed out that these study data reflect the early experience with the intraocular suspension before the technique of capsular bag administration was developed and before vortex mixers became available.

According to Jackson, the real-world retrospective data indicate the early favorable experience with dexamethasone intraocular suspension 9% for cataract surgery.

“The drug showed excellent inflammatory control, safety, and tolerability. Data from the Jacksoneye surgical site were comparable to the data from the other sites,” he concluded and pointed out that refining the administration technique has made use of the drug more straightforward.

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Mitchell A. Jackson, MD
E: mjlaserdoc@msn.co
This article is adapted from Jackson’s presentation at the American Society of Cataract and Refractive Surgery 2021 annual meeting. Jackson is a consultant to and speaker for EyePoint Pharmaceuticals, Inc.