Inadvertent Intralenticular Dexamethasone Implant for Diabetic Macular Edema Unresponsive to Bevacizumab

Hyo Kyung Lee; Se Yoon Chung; Kyung Eun Han; Min Chul Shin

doi:10.3341/jkos.2015.56.1.138

Journal List > J Korean Ophthalmol Soc > v.56(1) > 1010082

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Lee, Chung, Han, and Shin: Inadvertent Intralenticular Dexamethasone Implant for Diabetic Macular Edema Unresponsive to Bevacizumab

Original Article

J Korean Ophthalmol Soc 2015;56(1):138-141.

Published online: 6 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.1.138

Inadvertent Intralenticular Dexamethasone Implant for Diabetic Macular Edema Unresponsive to Bevacizumab

Hyo Kyung Lee, MD, Se Yoon Chung, MD, Kyung Eun Han, MD, Min Chul Shin, MD, 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

Received 27 September 201411 October 2014 Accepted 2 December 2014

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

Keywords: Crystalline lens, Dexamethasone implant, Diabetic macular edema, Ozurdex^®

References

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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.

Figure 2.

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

Figure 3.

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

Figure 4.

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

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