J Korean Ophthalmol Soc.  2016 Apr;57(4):662-666. 10.3341/jkos.2016.57.4.662.

Phacoemulsification and Intraocular Lens Implantation after Unexpected Intralenticular Injection of a Dexamethasone Implant

• Hwang JH
• Lee JH
• Kim JS

• KMID: 2212803
• DOI: http://doi.org/10.3341/jkos.2016.57.4.662

Abstract

PURPOSE
To report two cases of phacoemulsification and intraocular lens implantation after inadvertent intralenticular injection of a dexamethasone implant.
CASE SUMMARY
(Case 1) A 73-year-old male was referred to our hospital after an accidental intralenticular injection of a dexamethasone implant in a local clinic for treatment of branch retinal vein occlusion in his right eye. During the follow-up period, posterior capsular opacity progressed and phacoemulsification and intraocular lens implantation were performed 10 days later. During the surgery, the dexamethasone implant shattered and could not be repositioned into the vitreous cavity. The remnants of that implant were removed and a second dexamethasone implant was successfully injected into the vitreous cavity. (Case 2) A 69-year-old female was being treated for branch retinal vein occlusion in her left eye in our hospital. A dexamethasone implant was accidentally injected into her lens, thus phacoemulsification and intraocular lens implantation were performed the following day. During the procedure, we were able to successfully reposition the dexamethasone implant into the vitreous cavity.
CONCLUSIONS
Cataract formation after intralenticular injection of a dexamethasone implant can be easily managed with phacoemulsification. However, the dexamethasone implant shattered 10 days after the injection and could not be repositioned. The implant kept its hardness for at least one day and we were able to reposition it into the vitreous cavity without extending the rupture site of the posterior capsule.

Keyword

Dexamethasone implant; Intralenticular injection

MeSH Terms

Aged
Cataract
Dexamethasone*
Female
Follow-Up Studies
Hardness
Humans
Lens Implantation, Intraocular*
Lenses, Intraocular*
Male
Phacoemulsification*
Retinal Vein Occlusion
Rupture
Dexamethasone

Figure

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  Figure 1. Photograph showing inadvertent intralenticular injection of dexamethasone implant. Dexamethasone implant was inadvertently injected into the lens.

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  Figure 2. Intraoperative photograph. (A) Intraoperative photograph showing the dexamethasone implant located in the lens. (B) The dexamethasone implant shattered when retrieved with forceps.

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  Figure 3. Intraoperative photograph showing the dexamethasone implant in the lens.

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  Figure 4. Dexamethasone implant was inadvertently injected into the lens.

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  Figure 5. Intraoperative photograph when the dexamethasone implant was pushed into the vitreous cavity.

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  Figure 6. Change in needle of Ozurdex®

Reference

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