Ozurdex (Allergan, Irvine, California, USA) is a biodegradable sustained release intravitreal implant containing 0.7 mg dexamethasone in a solid polymer drug delivery system. In the UK, it is approved for use in patients with macular oedema secondary to retinal vein occlusion, diabetic maculopathy and non-infectious uveitis. Although the implant is meant to be injected into the vitreous cavity, it can be inadvertently injected into the crystalline lens. This can also migrate into the anterior chamber, under altered anatomical conditions of the anterior segment. We report a case of incompletely penetrated dexamethasone implant, in a patient undergoing treatment for macular oedema secondary to retinal vein occlusion. The partially penetrated implant was managed conservatively with a good outcome.

Objective To evaluate the safety and efficacy of phacoemulsification combined with Micropulse transscleral cyclophotocoagulation (MP-TSCPC) in glaucoma patients. Methods This is a retrospective case-note review. The participants were adult patients with diagnoses of glaucoma and cataract who required a further reduction in IOP or a reduction in the number of glaucoma drops. All consecutive patients who underwent cataract surgery (CS) combined with MP-TSCPC laser between October 2018 and July 2019 were included in the study. The effect on visual acuity (VA), intraocular pressure (IOP) and number of anti-glaucoma drops were evaluated at 6 and 12 months in addition to any complications that occurred during any time point of the study. Results 42 eyes were included in the study. Mean IOP was reduced from 19.5 ± 5.4 mmHg by 22.5% to 15.1 ± 4.6 at 6 months post-operatively and by 19.5% to 15 ± 6.6 mm Hg at 12 months (p < 0.001 at both time points). The number of anti-glaucoma medications also reduced significantly from 2.8 ± 1.3 to 1.6 ± 1.2 at 6 months and to 2.2 ± 1.3 at 12 months (p < 0.001 at both time points). The success rate was 56% at 6 months and 54% at 12 months. 54.7% of our patients who completed 12 months follow up had an improvement or unchanged vision at the last visits. Conclusion This is the first study evaluating the effect of cataract surgery combined with MP-TSCPC in glaucoma patients. We demonstrated that this led to a reduction in IOP and the number of anti-glaucoma medications at 6 and 12-month postoperatively. The majority of patients had either stable or better vision at 12 months follow-up.

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