Inadvertent injection of triamcinolone into the crystalline lens

Jalil, Assad; Chaudhry, Nadia; Gandhi, Jagdeep Singh; Odat, T M; Yodaiken, M

doi:10.1038/sj.eye.6702575

Cited by 8 publications

(8 citation statements)

References 5 publications

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“…Three cases in the literature report inadvertent injection of triamcinolone in eyes with age-related macular degeneration 12 and diabetic macular edema. 13,14 Jalil et al 12 operated on the eye 4 weeks after the injection because the lens remained opaque and fundus assessment was not possible.…”

Section: Discussionmentioning

confidence: 98%

“…13,14 Jalil et al 12 operated on the eye 4 weeks after the injection because the lens remained opaque and fundus assessment was not possible. Rajak et al 13 reported that the lens did not opacify until 7 months after the procedure and then, although the cataract had progressed, the patient did not have cataract extraction as the IOP was elevated to 42 mm Hg.…”

Section: Discussionmentioning

confidence: 98%

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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: 98%

Section: Discussionmentioning

confidence: 98%

Intravitreal dexamethasone implant in the crystalline lens

Karalezlı

Eroglu

2014

JCRS Online Case Reports

View full text Add to dashboard Cite

show abstract

“…Jalil A et al reported a case of an 87-year-old male suffering from macular subretinal neovascular membrane secondary to age-related macular degeneration [8]. Intravitreal triamcinolone injection was given 4 mm posterior to the limbus in the inferotemporal quadrant.…”

Section: Discussionmentioning

confidence: 99%

“…Several complications including cataract formation, raised intraocular pressure, and endophthalmitis have been reported following intravitreal injection of triamcinolone [4], [5], [6]. Inadvertent injection of the drug directly into the crystalline lens is a very rare complication and to the authors’ best knowledge has only been reported three times in the literature [7], [8], [9]. We herewith report the fourth case.…”

Section: Introductionmentioning

confidence: 97%