Surgical Management of Complications after Dexamethasone Implant.

Alessandra Sborgia,Francesco D’Oria,Giancarlo Sborgia,Giovanni Alessio,Luigi Sborgia,Francesco Boscia,Alessandra Galeone,Alfredo Niro

doi:10.1155/2020/4837689

Abstract

Purpose To report surgical management of ocular complications occurred after dexamethasone (DEX) implant (Ozurdex®) injection. Methods Retrospective interventional case series. Results Different surgical procedures including viscoexpression to manage the migration of the implant into the anterior chamber, “phaco-rolling” technique for the intralenticular injection, and vitrectomy with implant removal for an acute endophthalmitis were performed. Successful management of different complications after DEX implant by using individualized surgical approaches was observed. Conclusions Early and targeted surgical management is required in selected cases of ocular complications after DEX implant. The implant removal was needed to preserve ocular anatomy and function.

Highlights

The Ozurdex® (Allergan, Irvine, CA, USA) is a 700 mcg dexamethasone (DEX) biodegradable ocular implant, formulated in a solid polymer drug delivery system, designed to be injected into the vitreous using a 22-gauge applicator device
The earlier removal of the implant was performed to reduce the risk of irreversible corneal endothelial damage [6]
Coca-Rabinot et al reported a case series of two patients with accidental injection into the lens associated with raised intraocular pressure (IOP) responsive to the topical therapy

Summary

Introduction

The Ozurdex® (Allergan, Irvine, CA, USA) is a 700 mcg dexamethasone (DEX) biodegradable ocular implant, formulated in a solid polymer drug delivery system, designed to be injected into the vitreous using a 22-gauge applicator device. It is used to treat macular oedema (ME) related to diabetic retinopathy, noninfectious uveitis, and retinal vein occlusion [1]. Major complications of this steroid implant include conjunctival haemorrhage, induction or worsening of cataract, glaucoma, retinal detachment, and endophthalmitis [2]. We reported a case series of rare ocular complications related to DEX implant, successfully managed by individualized surgical approaches

Report of Cases

Discussion