J Korean Ophthalmol Soc.  2015 Jan;56(1):138-141. 10.3341/jkos.2015.56.1.138.

Inadvertent Intralenticular Dexamethasone Implant for Diabetic Macular Edema Unresponsive to Bevacizumab

• Lee HK
• Chung SY
• Han KE
• Shin MC

• KMID: 2216168
• DOI: http://doi.org/10.3341/jkos.2015.56.1.138

Abstract

PURPOSE
To report a case of inadvertent intralenticular slow-release dexamthasone implant (Ozurdex(R), Allergan Inc., Irvine, CA, USA) for diabetic macular edema unresponsive to bevacizumab.
CASE SUMMARY
A 71-year-old woman presented with proliferative diabetic retinopathy. During follow-up, diabetic macular edema developed in both eyes and did not improve with intravitreal bevacizumab injections. For refractory diabetic macular edema, slow-release dexamthasone implant (Ozurdex(R)) was to be injected at the vitreous cavity of her left eye, but it was inadvertently injected into the crystalline lens. The patient was followed closely for 10 months. Diabetic macular edema completely resolved 1 month after the injection and did not recur during follow-up. There were no severe complications except mild cataract formation. Best-corrected visual acuity for the left eye improved from 0.1 to 0.2. The Ozurdex(R) implant slightly decreased after 10 months, but was still observed in the crystalline lens.
CONCLUSIONS
The inadvertent intralenticular dexamthasone implant was a rare complication but effective for diabetic macular edema.

Keyword

Crystalline lens; Dexamethasone implant; Diabetic macular edema; Ozurdex(R)

MeSH Terms

Aged
Cataract
Dexamethasone*
Diabetic Retinopathy
Female
Follow-Up Studies
Humans
Lens, Crystalline
Macular Edema*
Visual Acuity
Bevacizumab
Dexamethasone

Figure

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  Figure 1. Initial fundus photograph (A) and optical coherence tomography (B) of left eye show proliferative diabetic retinopathy with macular edema.

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  Figure 2. Anterior segment photograph shows that the dex-amethasone implant inserted in the crystalline lens.

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  Figure 3. Optical coherence tomography of left eye shows improved macular edema after inadvertent intralenticular insertion of dexamethasone implant.

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  Figure 4. Anterior segment photograph reveals the remnant intralenticular dexamethasone implant and posterior subcapsular cataract at last follow-up.

Reference

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