Sympathetic ophthalmia is an autoimmune condition thought to be caused when one eye is severely damaged, and the immune system overreacts and attacks the healthy eye, often leading to complete blindness. Until recently the common treatment option was oral steroids and immunosuppressive medication, but now clinicians at the University of Iowa are using a steroid releasing implant from Bausch & Lomb to prevent such a form of blindness.
University of Iowa reports:
The new Retisert treatment involves the surgical implantation into the endangered eye of a small plastic tab that contains a slow-release steroid called fluocinoloe acetonide. The insert provides immunosuppression only to the endangered eye, not other body parts. It lasts for about two-and-a-half years and then can be replaced.
Along with UI retinal surgeons James Folk, M.D., professor of ophthalmology, and Karen Gehrs, M.D., clinical associate professor of ophthalmology, Mahajan published a retrospective paper online in January in the journal Ophthalmology that documents the successful use of Retisert to treat eight patients with sympathetic ophthalmia.
The device previously was studied in approximately 300 individuals who had a different immune system inflammation of the eye. The UI-led sympathetic ophthalmia study found that with Retisert, the eight patients reduced or eliminated use of systemic medications to control inflammation. While two patients needed to resume using an oral immunosuppressive, vision improved or remained stable in all eight patients.
“Using Retisert, we are stabilizing vision in patients with sympathetic ophthalmia and getting them off the heavy-duty immunosuppressive medications,” Mahajan said. “Patients had been willing to put up with the serious side effects of systemic immunosuppression because if they lost vision in their remaining good eye, it would be totally life-altering. With Retisert, we can save the eye, and the side effects are limited to treatable risks of high pressure or cataracts in the eye.”
While each implant costs approximately $20,000, their use appears to be less expensive over the long run compared to systemic immunosuppressive drugs and the required frequent hospital visits.
“If you add up the total number of patient visits, costs of lab tests and the costs of the immunosuppressive drugs, the $20,000 for the device is cheaper,” Mahajan said.
Press release: New surgical implant tested at UI prevents total blindness
Product page: RETISERT