Inadvertent intralenticular dexamethasone implant: one year follow-up and management

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Sunday 06/09/2015 | 10:30-12:30

Paper Time: 10:36

Venue: Room 10

First Author: : C.Caglar TURKEY

Co Author(s): :    M. Durmus                    

Abstract Details

Purpose:

To report a case of a 72-years-old woman presenting lens damage after dexamethasone implantation (Ozurdex, Allergan Inc, Irvine, CA, USA) for the treatment of ME secondary to hemicentral RVO and the management of the traumatic cataract related to inadvertent enjection.

Setting:

The Ophthalmology Department of Hitit University, Corum, Turkey.

Methods:

The patient was followed without repositioning of the dexamethasone implant during the 12-months. Besides, the posterior subcapsular cataract and ME had progressed significantly; hence, cataract extraction and intravitreal ranibizumab injection was performed in same session.

Results:

A cataract extraction was performed. At the end of the nucleus removal, a small defect in the inferior site of posterior capsule was identified: there was no vitreous on the capsule surface. The Ozurdex implant was aspirated using a phacoemulsification probe, and a three-piece intraocular lens was implanted in the sulcus with optic captured within intact anterior capsule. Ranibizumab was injected after cataract surgery into the vitreous for nux ME related to RVO in same session. The patient had an uncomplicated post-operative recovery. The intraocular lens position was normal. At 2 months BCVA was 0,7 and the macula was dry.

Conclusions:

Lens damage can be a complication of dexamethasone implant. In cases of inadvertent injection into lens, patients should be followed for development of cataract and elevation of intraocular pressure. During Ozurdex® injection, the direction of the needle should always be perpendicular to the scleral surface to avoid this complication. A careful cataract surgery can resolve anatomical damages. If there is a ME related to RVO in such cases, anti-VEGF injection can be performed after cataract surgery in same session. This is the first report of a patient who had performed cataract extraction together with intravitreal anti-VEGF injection in such cases.

Financial Interest:

NONE