Splitting of a Dexamethasone Implant (Ozurdex) following the Injection

Abstract

In this brief report, we share our observations on a splitted Dexamethasone implant (Ozurdex) which we discovered a week after the injection. It is likely that implant splitting neither changes the efficacy of the implant nor creates a mishap for the patient.

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

“…The desegmentation of Ozurdex apparently seems to be innocuous without any immediate or early intraocular complications. Similar to the cases described by Rishi et al 5 and Donmez et al, 6 there were no consequential adverse effects of fractured Ozurdex implant in either of the cases reported here. The efficacy of the drug normally reduces at 2 months, and this was observed in both our cases.…”

“…To the best of our knowledge, these are the only cases of fractured implant after the cases reported by Rishi et al 5 and Domez et al 6 In addition, our cases demonstrate normal efficacy of implants in two and three pieces over time. With more and more microsurgical implantation procedures, clinicians should be well aware of these unusual although rare 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].…”