Patient Education
Sustained-Release Steroid Implants
In-office · effect lasts months to years
Steroid implants are tiny drug depots placed inside the eye that release anti-inflammatory medication slowly over months. Because swelling in the retina is often driven by inflammation as well as by leaking vessels, a steroid can succeed where anti-VEGF injections alone have not — and because the implant releases its drug gradually, it can replace many frequent injections with one.
Steroid implants are tiny drug depots placed inside the eye that release anti-inflammatory medication slowly over months. Because swelling in the retina is often driven by inflammation as well as by leaking vessels, a steroid can succeed where anti-VEGF injections alone have not — and because the implant releases its drug gradually, it can replace many frequent injections with one. Options include dexamethasone (Ozurdex), lasting several months, and fluocinolone implants (Iluvien, Yutiq), lasting up to three years.
What It Treats
- Diabetic macular edema
- Macular edema from retinal vein occlusion
- Chronic non-infectious uveitis
- Cystoid macular edema after cataract surgery
What to Expect
Before
Your doctor will check your eye pressure history and whether you still have your natural lens, since both affect the choice of implant. Patients whose pressure rises sharply on steroids may not be candidates.
During
The eye is numbed and prepped the same way as for any injection. The implant is placed through a specialized applicator — the needle is slightly larger than a standard injection needle, so you may feel a little more pressure. It still takes only seconds.
After
Some patients can see the implant as a small dark line or speck in their peripheral vision for the first days or weeks. It is harmless, and it dissolves on its own in the case of dexamethasone.
Recovery & Restrictions
- Same-day recovery as a standard injection: a driver, blurring for a few hours, and a scratchy feeling.
- You will need pressure checks over the following months — often at around six weeks and then periodically, since steroid-related pressure rises are usually delayed.
- If you have not had cataract surgery, expect the cataract to progress faster. This is common enough that many patients eventually need cataract surgery, which is a routine and effective operation.
- The retina usually dries over the first weeks, and the effect fades toward the end of the implant's life — so retreatment is scheduled by the calendar as much as by symptoms.
Risks & Side Effects
Raised eye pressure and glaucoma
The most important risk. A substantial minority of patients need pressure-lowering drops, and a small number need glaucoma surgery. This is why pressure is monitored on a schedule rather than only when symptoms appear.
Cataract
Steroids inside the eye reliably speed up cataract formation. In eyes that still have their natural lens, this is expected over time rather than unusual.
Implant migration
Rarely the implant moves forward into the front chamber of the eye, particularly in eyes that have had complex prior surgery. It can usually be repositioned or removed.
The usual injection risks
Infection inside the eye, surface bleeding, and floaters, as with any intravitreal injection.
Every procedure carries risk, and this list is not exhaustive. Your doctor will discuss the risks that apply to your eye and your circumstances before you decide.