Table 3.

General Pre- and Post-Injection Action Protocol for FAc Implant Treatment

Medical Exam (Pre-injection)

An OCT examination should be performed to detect signals of ellipsoid zone integrity, hyperreflective dots, DRIL and intraretinal or subretinal fluid, and to generate an image of what the patient’s prognosis could be.

Goldmann applanation tonometry and retinal nerve fiber layer OCT analysis, as well as visual field examination (optional), should be performed in order to obtain baseline information about the IOP level, optic disc anatomy and cup-to-disc ratio. This baseline information will be useful to compare with future follow-up information.

The use of the FAc implant in aphakic patients should be analyzed according to the benefit–risk assessment because of the risk of migrating the implant into the anterior chamber.

Comment from the group of experts: Most physicians adhere to the published summary of product characteristics (SmPC) showing that glaucoma is considered a contraindication for the use of the FAc implant.70

Follow-up checks for 36 months (post-injection)

Check at one week post-injection to exclude any adverse effects related to the intravitreal injection, and then follow the patient every 3 months (eg, using information from the SmPC).70

In the follow-up visits, the anatomical efficacy of the treatment should be tested using OCT to look at central macular thickness (CMT) and macular volume. The functional efficacy (ie, BCVA) should be checked. Fundus and diabetic retinopathy status/progression should also be checked.