Dexamethasone Implant-associated Vitreous Floaters and Symptom Improvement by YAG Laser Vitreolysis

Abstract

Purpose:To investigate the incidence of symptomatic floaters following intravitreal dexamethasone implant therapy and to propose implant repositioning using neodymium-doped yttrium aluminum garnet (Nd:YAG) vitreolysis around the implant for treatment. Case summary: Nd:YAG vitreolysis was performed on the superior vitreous adjacent to the dexamethasone implant in eyes with persistent symptomatic floaters following intravitreal dexamethasone implant injection using 2.0-3.0 mJ energy. Among 172 injections of the dexamethasone implant, 11 (6.4%) resulted in symptomatic floaters at the 1-month visit. Three (1.7%) eyes exhibited persistent and visually significant vitreous floaters, upon which Nd:YAG vitreolysis was performed. Immediately after the superior vitreolysis adjacent to the implant, the implants were repositioned to the inferior vitreous. Floater symptoms were resolved in all patients without any damage to the implant or other ocular complications. Conclusions: Superior vitreolysis adjacent to dexamethasone implants may be an effective and safe treatment for persistent symptomatic floaters following intravitreal dexamethasone implant injection.