Immortal Ozurdex: A 10-month follow-up of an intralenticular implant

Abstract

A 78-year-old male who had received a dexamethasone implant (Ozurdex, Allergan, Inc., Irvine, CA, USA) 15 days back for recalcitrant diabetic macular edema in the left eye came to us for a second opinion. On examination, his corrected distance visual acuity was 20/20 in the right eye and 20/40 in the left eye. Early cataractous changes were present in both eyes. The intraocular pressure was within normal limits. The Ozurdex implant was seen lodged in the posterior cortex of the crystalline lens in the left eye, confirmed on anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy. Fundus examination showed moderate nonproliferative diabetic retinopathy in both eyes with macular edema and epiretinal membrane in the left eye, confirmed on OCT. The patient was noncompliant and returned after 10 months. Interestingly, the implant was still present in the same location with the same vision and anterior segment findings as before. The OCT showed a reduction in macular edema. The patient was advised regular follow-up and cataract surgery at a later date.

Intralenticular Ozurdex® – One Year Later

“…Despite its intralenticular location, the implant may still improve or resolve macular edema, as intended [ 1 , 7 , 8 , 9 ] and as was seen in our patient. The achievement of therapeutic vitreous concentration levels despite complete sequestration within the lens is also unknown.…”

“…Prior case reports of intralenticular Ozurdex that received no intervention for 10 months reveal the potential stability of the implant inside the crystalline lens. These patients had stable vision with no or minimal progression of a cataract [ 1 , 2 ]. Although there was no IOP exacerbation following Ozurdex in our patient with ocular hypertension, IOP elevation has been previously reported, and it may be an indication for lens removal even in the absence of cataract [ 2 ].…”

“…It is delivered via a prepackaged 22-gauge injection device. The literature reveals previous cases of inadvertent intralenticular administration of Ozurdex [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. We report the case of a 60-year-old woman who was found to have an Ozurdex implant in the crystalline lens of the left eye in the setting of previously treated proliferative diabetic retinopathy with refractory diabetic macular edema (DME).…”

Morphological and Functional Outcomes after Intravitreal Dexamethasone Injection for Macular Edema in Patients with Central Vein Occlusion at 48-Week Follow-Up

“…ere are some conflicting studies that reported no cataract progression even after accidental intralenticular Ozurdex implant administration [24,25]. In addition, many authors have revealed a resolution of the ME with an intralenticular implant [24,[26][27][28][29].…”

“…In the BRVO group, the mean CFT value was 430.25 ± 100.5 μm at baseline and decreased to 301. 25 Figure 2). CFT values at each control visit improved significantly compared with baseline CFT values (p � 0.012 at 4 weeks, p � 0.0103 at 8 weeks, p < 0.0001 at 12 weeks, 24 weeks, and 48 weeks).…”