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Phacoemulsification and anterior vitrectomy surgery for inadvertent intralenticular Ozurdex implant

Poster Details

First Author: I.Ucar TURKEY

Co Author(s):    R. Karadag   E. Bulut   A. Demirok              

Abstract Details

Purpose:

We report a case of inadvertent injection of dexamethasone implant into the crystalline lens, its effects and management.

Setting:

─░stanbul Medeniyet University School of Medicine Goztepe Research and Training Hospital, Depertment of Ophthalmology

Methods:

A 67-year-old man presented with 5 months history of blurred vision on his left eye. His best-corrected visual acuity (BCVA) was 3/10. Angiography confirmed branch retinal vein occlusion with diffuse macular edema. Intravitreal dexamethasone implant injection and retinal laser photocoagulation was planned. At first, Ozurdex implantation was performed. Two weeks later laser photocoagulation was applied. His BCVA decreased to 1/10 on his routine follow-up visit at fourth week after ozurdex implantation. IOP was 60 mmHg. Two Ozurdex implants were seen; one of them was located inside the posterior pole of the crystalline lens and another was located in anterior vitreous.

Results:

Phacoemulsification surgery was performed. After nucleus removal, a posterior capsular defect was noted around the Ozurdex implant. Anterior vitrectomy was performed. Because of high IOP both of Ozurdex implants were removed. Three piece hydrophobic acrylic intraocular lens was implanted into the ciliary sulcus. The first day after surgery BCVA was 4/10 and IOP was 19 mmHg. A reduction in macular edema was noted and confirmed on OCT.

Conclusions:

In case of inadvertent injection of Ozurdex implant into the crystalline lens can be resulted with fragmentation of the implant, patients should be followed for the development of cataract or elevation in IOP. It does not always necessitate immediate surgical removalbut if there is an increase in IOP or cataract development is detected surgery should be planned as soon as possible.

Financial Disclosure:

None

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