Intracrystalline Ozurdex®: therapeutic effect maintained for 18months.

Abstract

Ozurdex® is a sterile, sustained-release implant of dexamethasone. The device dissolves within the vitreous body and releases dexamethasone. Here we present a clinical case that demonstrates the sustained therapeutic efficacy of Ozurdex® when accidentally injected into the crystalline lens. Case report. Sixty-three-year-old male in which we decided to prescribe the intravitreal injection of a dexamethasone implant (Ozurdex®) in the left eye because of macular oedema after branch retinal vein occlusion. Best-corrected visual acuity (BCVA) was 0.4. At 15days post-implantation, the slit-lamp examination revealed the dexamethasone implant was located in the crystalline lens. Given there was no inflammation in the anterior pole, no cataracts had developed, the intraocular pressure (IOP) was normal and the macular oedema had been resolved, we decided to assess the efficacy and safety of the dexamethasone implant located in the crystalline lens. The BCVA improved until 14months post-accidental injection. At 18months post-Ozurdex® injection the BCVA worsened until 0.05 because of the cataract evolution. Phacoemulsification and intraocular lens placement in sulcus was performed. Once the complication has occurred, most authors advocate the early withdrawal of the implanted Ozurdex® device by means of crystalline phacoemulsification and then repositioning it in the vitreous body. However, as long as there are no signs of inflammation in the anterior pole, the IOP is within normal limits, the device does not affect the visual axis and there is no cataract development, we can evaluate the potential therapeutic effect of Ozurdex® in this non-indicated, abnormal location.