Guidance on accommodating intraocular lenses from the National Institute for Health and Clinical Excellence (NICE, 2007) concluded: "Current evidence suggests that there are no major safety concerns associated with the implantation of accommodating lenses for cataract. There is evidence of short-term efficacy in correcting visual acuity but there is inadequate evidence that the procedure achieves accommodation. Therefore, the procedure should not be used without special arrangements for consent and for audit or research." The assessment stated that publication of long-term efficacy outcomes of the procedure will be useful, particularly on the effects on accommodation.
Dexamethasone is absorbed rapidly after oral administration with a half-life of about 190 minutes. Sufficient absorption may occur after topical application to the skin and eye to produce systemic effects. In plasma dexamethasone protein binding is less than for most other corticosteroids. Corticosteroids diffuse into tissue fluids and cerebrospinal fluid but transplacental diffusion in significant amounts has not been demonstrated. Corticosteroids are metabilised in the liver the kidney and excrete in the urine. Metabolism is similar to other corticosteroids. Intraocular penetration occurs in significant amounts and contributes to the effectiveness of dexamethasone in anterior segment inflammatory disease.