Anterior chamber migration of dexametasone intravitreal implant (Ozurdex®)

Pardo-López, Diamar; Francés-Muñoz, Ester; Gallego-Pinazo, Roberto; Díaz-Llopis, M.

doi:10.1007/s00417-011-1802-x

Cited by 80 publications

(48 citation statements)

References 4 publications

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“…[15][16][17] The main complication in these reports was anterior chamber migration of the implant. In our case, because the applicator needle was not perpendicular to the vitreous cavity, the needle was advanced into the lens and the dexamethasone implant was injected into the crystalline lens.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal dexamethasone implant in the crystalline lens

Karalezlı

Eroglu

2014

JCRS Online Case Reports

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We report the case of a 58-year-old man who developed macular edema due to superior temporal vein occlusion in his right eye. A dexamethasone implant was inadvertently injected into the crystalline lens. Slitlamp examination revealed the position of the implant. The intralenticular dexamethasone implant was clearly imaged in front of the posterior lens capsule by highfrequency ultrasound biomicroscopy. The patient was followed without repositioning of the dexamethasone implant. During the 6-month follow-up, no additional side effect was observed, the macular edema decreased, and the vision improved.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. JCRS Online Case Reports 2014; 2:e12-e15 Q 2014 ASCRS and ESCRSRetinal vein occlusion is considered the second most common retinal vascular disorder after diabetic retinopathy. 1 Cystoid macular edema (CME) is a common sight-threatening complication of retinal vein occlusion. 2 Multiple treatment strategies have been attempted for the treatment of macular edema, including laser photocoagulation, antivascular endothelial growth factor, and corticosteroid injections. 3 The dexamethasone intravitreal implant (Ozurdex), a biodegradable implant of dexamethasone (0.7 mg) used as injection into the vitreous cavity, has recently become a valuable treatment option for eyes with visual impairment due to macular edema related to central retinal vein occlusion and branch retinal vein occlusion. This rod-shaped implant is 6.0 mm in length and 0.46 mm in diameter. The implant dissolves in the vitreous while slowly releasing the dexamethasone for up to 6 months. It has been approved by U.S. Food and Drug Administration for the treatment of macular edema secondary to retinal vein occlusion and noninfectious uveitis affecting the posterior segment. 4,5 As a consequence of increased popularity of intravitreal injections, many complications such as intraocular pressure (IOP) elevation, cataract formation, endophthalmitis, intraocular hemorrhage, hypotony, and retinal detachment have been reported. 6,7 We report an inadvertent injection of a dexamethasone implant into the crystalline lens. To our knowledge, this is the first report of a patient with an inadvertent dexamethasone implant without repositioning in the absence of side effects. CASE REPORTA 58-year-old man presented with a 3-day history of decreased vision in his right eye. The corrected distance visual acuity (CDVA) was 1.0 logMAR (decimal equivalent of 0.1) in the right eye and 0 logMAR (decimal equivalent of 1.0) in the left eye. Intraocular pressure was 17 mm Hg and 16 mm Hg, respectively. Anterior segment examination revealed early nuclear cataract in both eyes. Fundus examination showed macular edema and retinal hemorrhages in the superior retina of the right eye (Figure 1, A). Optical coherence tomography (OCT) revealed CME with a central macular thickness of 579 mm (Figure 1, B). Clinical findings and investigations confirmed superior branch retinal vein occ...

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Section: Discussionmentioning

confidence: 99%

Intravitreal dexamethasone implant in the crystalline lens

Karalezlı

Eroglu

2014

JCRS Online Case Reports

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“…Ozurdex ® is based on NOVADUR ® CR platform, where dexamethasone is combined with the biodegradable PLGA to form a small rod-shaped implant. The implant slowly degrades following administration allowing for CR of dexamethasone as it diffuses through the polymer and as the polymer erodes [48]. Meanwhile, Retisert ® and Iluvien ® are fluocinolone acetonide (FA)-containing non-biodegradable implants, based on silicone elastomers and polyimide/ polyvinyl alcohol, respectively, which will allow the slow release of FA through diffusion.…”

Section: Inflammationmentioning

confidence: 99%

Controlled release drug delivery systems to improve post-operative pharmacotherapy

Bhusal

Harrison

Sharma

et al. 2016

Drug Deliv. and Transl. Res.

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Over 230 million surgical procedures are conducted worldwide each year with numbers increasing. Pain, undesirable inflammation and infection are common complications experienced by patients following surgery. Opioids, non-steroidal anti-inflammatory drugs (NSAIDs), local anaesthetics (LAs) and antibiotics are the commonly administered drugs peri-operatively to manage these complications. Post-operative pharmacotherapy is typically achieved using immediate-release dosage forms of drugs, which lead to issues around fluctuating plasma concentrations, systemic adverse effects and poor patient adherence. Controlled release (CR) systems for certain medicines including opioids, NSAIDs and antibiotics have demonstrably enhanced treatment efficacy in the post-surgical setting. However, challenges remain to ensure patient safety while achieving individual therapeutic needs. Newer CR systems in the research and development pipeline have a high level of control over medicine release, which can be initiated, tuned or stopped on-demand. Future systems will self-regulate drug release in response to biological markers providing precise individualized therapy. In this review, we cover currently adopted CR systems in post-operative pharmacotherapy, including drug eluting medical devices, and highlight a series of examples of novel CR technologies that have the potential for translation into post-surgical settings to improve medication efficacy and enhance post-surgical recovery.

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“…We registered one case of anterior chamber migration resulting in a bullous keratopathy. 2 The mean age of patients with CRVO (n ¼ 23) was 68.3. In eye receiving a second Ozurdex implant, four out of the six phakic eyes showed progression of cataract requiring surgery.…”

Section: Conflict Of Interestmentioning

confidence: 99%