Desegmentation of Ozurdex implant in vitreous cavity: report of two cases

Abstract

With more and more microsurgical implantation procedures, clinicians should be well aware of these unusual although rare complications. Even though the desegmented implants do not appear to cause more intraocular complications compared with single-piece implants, patients with defragmented implants should be followed up carefully to monitor for unexpected complications.

Does Intravitreal Dexamethasone Implant Fragmentation Affect Clinical Outcomes in Macular Edema from Branch Retinal Vein Occlusion

“…Another unexpected adverse event has also been reported recently: between 2012 and 2014, 5 cases of fragmentation of dexamethasone implants immediately after intravitreal injection were reported [7,8,9,10]. This adverse event is of concern because it could alter the amount of dexamethasone that is released into the vitreous.…”

“…In 2012-2104, 5 cases of fragmentation of the dexamethasone implant immediately after its intravitreal implantation were reported [7,8,9,10]. The possibility that the implant could fragment after implantation, and its possible clinical effects, are not mentioned in the prescribing information for this implant [16].…”

Corticosteroids for the Treatment of Diabetic Macular Edema

“…The dexamethasone implant has also been found to be trapped anterior to the anterior hyaloid face and between the posterior capsule and a silicon oil bubble, in both cases it spontaneously relocated to the inferior vitreous cavity without any other complications [99,100]. Fragmentation of the implant has been noted to occur during injection or shortly thereafter; fortunately, this does not change the rate or duration of drug delivery in the eye [101][102][103][104]. Inadvertent injection of the dexamethasone implant into the crystalline lens can be safely and successfully managed by standard cataract extraction with phacoemulsification [105,106].…”

Anterior Chamber Dislocation Of Ozurdex Implant: A Case Report

“…Ozurdex is associated with ocular side effects, such as conjunctival hemorrhage, endopthalmitis, cataracts, glaucoma, and retinal detachment (2). There may also be complications due to the implant itself, such as desegmentation (fracture) of the implant, accidental injection of Ozurdex into the crystalline lens, and migration of the Ozurdex implant into the anterior chamber (3)(4)(5). This report describes a case of corneal toxicity occurring after migration of a DEX implant into the anterior chamber.…”