Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Am J Ophthalmol. 2012 Dec;154(6):969-973.e1. doi: 10.1016/j.ajo.2012.06.004. Epub 2012 Sep 13.
To characterize the phenomenon of dissociation of the 2 components of the sustained-release fluocinolone acetonide implant (Retisert; Bausch & Lomb) during removal or exchange procedures, or both, and to evaluate outcomes after these events.
Retrospective, observational case series.
Retrospective review of 27 consecutive sustained-release fluocinolone acetonide implant (Retisert) exchanges or removals between 2001 and 2010 at the Cole Eye Institute. All patients had received the implant as treatment for noninfectious uveitis. Preoperative and postoperative characteristics were analyzed, and operative reports were reviewed to characterize the effects of intraoperative implant dissociation.
Twenty-seven sustained-release fluocinolone acetonide implant (Retisert) exchange or removal surgeries were performed by 3 surgeons in 20 eyes of 19 patients. Of these 27 procedures, dissociation of the implant strut from the drug-containing cup occurred in 11 eyes (40.7%). Retrieval of the dislocated cup led to intraoperative complications, including posterior retinal tear (n = 1) and limited suprachoroidal hemorrhage (n = 1). The length of time that the implant resided in the eye correlated significantly with cup dissociation. Dissociated implants resided a mean of 47.4 months, whereas intact implants resided a mean of 32.5 months (P = .0032). There was no long-term or short-term vision loss attributed to intraoperative implant dissociation.
Sustained-release fluocinolone acetonide implant (Retisert) dissociation is a common occurrence in exchange or removal procedures, or both. The longer an implant resided in the eye, the greater the tendency toward dissociation. Preparation for this complication should be contemplated in any implant removal or exchange procedure.
描述在移除或更换过程中（或两者均有），氟轻松醋酸酯持续释放植入物（Retisert；Bausch & Lomb）的 2 个组成部分分离的现象，并评估这些事件后的结果。
回顾性、观察性病例系列研究。
对 2001 年至 2010 年间在 Cole 眼研究所进行的 27 例连续氟轻松醋酸酯持续释放植入物（Retisert）更换或移除手术进行回顾性分析。所有患者均因非感染性葡萄膜炎接受了该植入物治疗。分析了术前和术后的特征，并对手术报告进行了回顾，以描述术中植入物分离的影响。
由 3 名外科医生对 19 名患者的 20 只眼进行了 27 例氟轻松醋酸酯持续释放植入物（Retisert）更换或移除手术。在这 27 例手术中，有 11 只眼（40.7%）的植入物支柱与含药杯分离。脱位杯的取出导致术中并发症，包括后视网膜裂孔（1 例）和局限性脉络膜下出血（1 例）。植入物在眼内停留的时间与杯状分离显著相关。分离的植入物平均停留 47.4 个月，而完整的植入物平均停留 32.5 个月（P =.0032）。没有因术中植入物分离而导致长期或短期视力丧失。
氟轻松醋酸酯持续释放植入物（Retisert）在更换或移除过程中（或两者均有）分离是一种常见现象。植入物在眼内停留的时间越长，分离的趋势就越大。在任何植入物移除或更换手术中都应考虑到这种并发症的准备。
