Intravitreal Acetazolamide Implant For Pseudophakic Cystoid Macular Edema
Published 2026 - 44th Congress of the ESCRS
Reference: PP02.07 | Type: Free paper | DOI: 10.82333/70xy-mx77
Authors: A/Prof. Andre Messias* 1 , A/Prof. Rodrigo Jorge 1 , Ms Isabela Vilela 1
1Ophthalmology,University of São Paulo,Ribeirão Preto,Brazil
Purpose
To investigate the safety of a slow-delivery intravitreal acetazolamide implant (260 μg) for the treatment of cystoid macular edema (CME) in patients who are refractory, relapsing, or intolerant to conventional therapy
Setting
Terciary University Ophthalmology Hospital
Methods
After informed consent, patients received a single intravitreal injection of a 260 μg acetazolamide implant via pars plana, using a 25-gauge trocar-cannula (Alcon, Fort Worth, Texas). Follow-up included comprehensive ophthalmologic examination, spectral-domain optical coherence tomography (OCT), full-field or multifocal electroretinography (ERG), and laboratory testing.
Results
Significant anatomical improvement was observed in all cases, with marked reductions in central macular thickness on OCT. Visual acuity either improved or remained stable. Notably, full-field and multifocal ERG showed no changes in amplitude, latency, or waveform morphology in any patient—providing no indication of retinal toxicity whatsoever. Intraocular pressure remained stable or decreased, including in patients with pre-existing glaucoma.
Conclusions
These preliminary findings suggest that intravitreal delivery of acetazolamide via implant may be a safe and effective option for managing refractory CME. The absence of any detectable ERG abnormalities supports the retinal safety of this novel therapeutic approach. Further studies are needed to validate these early results.