Surgical Management of Complications after Dexamethasone Implant

Sborgia, Giancarlo; Niro, Alfredo; D’Oria, Francesco; Galeone, Alessandra; Sborgia, Luigi; Boscia, Francesco; Sborgia, Alessandra; Alessio, Giovanni

doi:10.1155/2020/4837689

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Specifically, they reported migration of the implant into the anterior chamber (2 eyes), acute endophthalmitis (1 eye) and accidental intralenticular implant (1 eye). 5 During a retrospective multicentric case series study of 21,653 patients, Meyer et al found an incidence of 0,009% (2/21,653 eyes) for lens damage in phakic eyes. 6 In our case, the patient was affected by acromegaly.…”

Section: Discussionmentioning

confidence: 99%

Effect of intralenticular dexamethasone implant: A case report

Carnevali

Taloni

Gatti

et al. 2023

European Journal of Ophthalmology

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Introduction Intravitreal dexamethasone (DEX) implant is indicated for the treatment of macular oedema due to diabetic retinopathy, retinal vein occlusion and uveitis. The most common complications are cataract and elevated intraocular pressure (IOP). Accidental injection of DEX implant into the lens is a rare complication and only few papers presented it. Case Presentation A 40-year-old man was treated with DEX implant for diabetic macular oedema in both eyes. At 1 week follow-up visit, slit lamp examination showed the DEX implant was located in the crystalline lens of the right eye (RE) without any sign of inflammation, cataract or elevated IOP, so we decided to plan a normal follow-up schedule. Macular oedema relapsed 5 months after the injection in the left eye (LE), whereas the RE did not show any sing of intraretinal or subretinal fluid. Six months after DEX implantation an uneventful phacoemulsification and intraocular lens placement were performed in the RE because of IOP elevation. Conclusions The therapeutic effect of DEX implant can be maintained for a longer period of time than intravitreal implant, determining complete reabsorption of macular oedema. Intralenticular implant can be maintained inside the lens until either IOP increases, cataract progresses, or other complications occur.

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Section: Discussionmentioning

confidence: 99%

Effect of intralenticular dexamethasone implant: A case report

Carnevali

Taloni

Gatti

et al. 2023

European Journal of Ophthalmology

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“…Zu den schwerwiegenden Komplikationen zählen erhöhte Augeninnendrücke (0,1 %), Glaskörperblutungen (0,1 %), Netzhautrisse und -ablösungen (0,01 %) sowie intraokulare Entzündungen und Endophthalmitiden (0,01-0,07 %) [3,4]. Die Inzidenz iatrogener Linsenverletzungen ist mit < 0,1 % sehr gering und wird in der Literatur lediglich in einzelnen Fallberichten insbesondere mit dem Slow-Release-Präparat Dexamethason beschrieben [5][6][7][8][9][10][11]. In den Zulassungsstudien ANCHOR und MARINA wurde lediglich 1 Fall eines Linsentraumas nach 9242 Injektionen über einen Zeitraum von 12 Monaten beobachtet [12,13].…”

Section: Hintergrundunclassified

Linsenverletzungen als Komplikation bei intravitrealer Medikamenteneingabe

Clemens,

Alten,

Eter

et al. 2024

Ophthalmologie

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Zusammenfassung Hintergrund Die intravitreale operative Medikamenteneingabe (IVOM) ist eine effiziente und risikoarme Applikationstechnik in der Behandlung unterschiedlicher Netzhauterkrankungen. Zu den seltenen schwerwiegenden Komplikationen zählen erhöhte Augeninnendrücke, Glaskörperblutungen, Netzhautrisse und -ablösungen sowie intraokulare Entzündungen und Endophthalmitiden. In der hier vorliegenden Fallserie berichten wir über iatrogene Linsenverletzungen. Methoden Es erfolgte eine multizentrische Datenerhebung von IVOM-Patienten mit sichtbaren iatrogenen Linsendefekten, retrospektiv über den Zeitraum 2016 bis 2023. Ergebnisse In 6 Fällen (69,3 Jahre ± 6,5) wurde ein Linsentrauma nach IVOM identifiziert. Während in 5 Fällen eine Anti-VEGF-Therapie vorausgegangen war, stellten wir in einem Fall eine Linsenverletzung nach Dexamethason-Implantation fest. Schlussfolgerungen Linsenverletzungen im Rahmen der IVOM sind eine seltene Komplikation und bei sachgemäßer Injektionstechnik vermeidbar. Kenntnisse über die individuelle Bulbusachsenlänge und den Linsenstatus tragen zusätzlich zur Vermeidung dieser Komplikation bei.

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“…Over the past decade, there have been an increasing number of case reports describing the migration of DEX implants into the anterior chamber (AC). 2 – 13 Some of these cases have been effectively managed with a combination of patient positioning, dilation, and gentle tapping on the eye, permitting repositioning of the implant back into the vitreous cavity. 3 , 5 Others have described urgent surgical removal of the implant from the AC.…”

Section: Introductionmentioning

confidence: 99%

Management and Complications of Dexamethasone Intravitreal Implant Migration Into the Anterior Chamber

Betsch

Gupta

2022

Journal of VitreoRetinal Diseases

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Purpose: To report patient demographics, the clinical course, and visual outcomes across a case series of patients who experienced dexamethasone (DEX) intravitreal implant (Ozurdex, Allergan, Inc) migration into the anterior chamber (AC), with a focus on the corneal transplantation rate. Methods: In this retrospective cross-sectional study, a chart review of all cases was performed. For numerical responses, means and SDs were calculated. Percentages and absolute numbers were used to report the proportion of patients who experienced various outcomes of interest. Results: The study comprised 32 cases. All cases occurred in pseudophakic eyes; of those, 8 (25.0%) had posterior chamber intraocular lenses in the capsular bag with no known capsular or zonular issues. The mean duration from DEX implant injection to detection of migration was 19.4 ± 14.5 days. The DEX implant was explanted in 21 patients (65.6%) and repositioned in the vitreous cavity or subconjunctival space in 6 patients (18.8%). Twelve patients (37.5%) ultimately required corneal transplantation. Conclusions: To our knowledge, this is the largest case series of DEX intravitreal implant migration into the AC compiled to date. Cases of migration occurred in individuals with no known history of significant prior zonule disruption. This potential complication should be discussed with all patients undergoing DEX implant injection, which may aid in earlier presentation and improved visual outcomes.

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Surgical Management of Complications after Dexamethasone Implant

Cited by 6 publications

References 20 publications

Effect of intralenticular dexamethasone implant: A case report

Effect of intralenticular dexamethasone implant: A case report

Linsenverletzungen als Komplikation bei intravitrealer Medikamenteneingabe

Management and Complications of Dexamethasone Intravitreal Implant Migration Into the Anterior Chamber

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