Dexamethasone Intracameral Drug-Delivery Suspension for Inflammation Associated with Cataract Surgery A Randomized, Placebo-Controlled, Phase III Trial

Purpose: To evaluate the safety and efficacy of an anterior chamber intracameral dexamethasone drug-delivery suspension (IBI-10090; DEXYCU; Icon Bioscience Inc., Newark, CA) that provides medication for up to 21 days with a single application in treating postoperative inflammation in patients undergoing cataract surgery. Design: Prospective, randomized, double-masked, multicenter trial. Participants: Patients with preoperative best-corrected visual acuity of 20/30 to 20/ 200 undergoing unilateral cataract surgery by phacoemulsification were randomized to receive IBI-10090 or placebo. Methods: Three hundred ninety-four patients were randomized 1: 2: 2 to receive 5-mu l injections of placebo or 5-ml injections of 342 or 517-mu g IBI-10090 dexamethasone drug delivery suspension injected into the anterior chamber at the conclusion of cataract surgery. Patients were followed for 90 days after surgery. Main Outcome Measures: Primary outcome was anterior chamber cell (ACC) clearing (ACC score of 0) in the study eye at postoperative day (POD) 8. Secondary outcome measures were anterior chamber flare and ACC plus flare clearing in the study eye. Ocular and nonocular adverse events were assessed. Results: Anterior chamber cell clearing at POD 8 was achieved in 25.0% of eyes in the placebo group and in 63.1% and 66.0% of eyes in the 342- and 517-mu g treatment groups, respectively (P < 0.001). Anterior chamber flare clearing at POD 8 was achieved by 63.8% of eyes in the placebo group and in 92.4% and 89.1% of eyes in the 342- and 517-mu g IBI-10090 treatment groups, respectively (P < 0.001). Anterior chamber cell plus flare clearing at POD 8 was achieved in 33.8% of eyes receiving placebo and in 63.1% and 67.3% of eyes receiving 342- and 517-mu g IBI-10090, respectively (P < 0.001). Adverse events among the 3 groups were similar, and no serious ocular adverse events were reported up to POD 90. Conclusions: The IBI-10090 dexamethasone drug-delivery suspension placed in the anterior chamber after cataract surgery at concentrations of 342 and 517 mg was safe and effective in treating inflammation occurring after cataract surgery and may be an alternative to corticosteroid drop installation in this patient population. (C) 2018 by the American Academy of Ophthalmology.