JKOS Journal of the Korean Ophthalmological Society J Korean Ophthalmol Soc 0378-6471 2092-9374 Korean Ophthalmological Society 10.3341/jkos.2015.56.1.138 jkos-56-138 Original Article Inadvertent Intralenticular Dexamethasone Implant for Diabetic Macular Edema Unresponsive to Bevacizumab LeeHyo KyungMD ChungSe YoonMD HanKyung EunMD ShinMin ChulMD, PhD Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea Address reprint requests to Min Chul Shin, MD, PhD, Department of Ophthalmology, Hallym University Chuncheon Sacred Heart Hospital, #77 Sakju-ro, Chuncheon 200-704, Korea, Tel: 82-33-240-5000, Fax: 82-33-255-6244 E-mail: mcshin@hallym.ac.kr 09 2015 06 09 2015 56 1 138 141 2792014 11102014 2122014 Copyright © 2015 Korean Ophthalmological Society 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

To report a case of inadvertent intralenticular slow-release dexamthasone implant (Ozurdex®, 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®) 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® 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. J Korean Ophthalmol Soc 2015;56(1):138-141

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

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

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

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