Medical Retina Service, Moorfields Eye Hospital, London, UK.
Br J Ophthalmol. 2014 Jul;98(7):961-3. doi: 10.1136/bjophthalmol-2014-304866. Epub 2014 Mar 19.
To report two cases of desegmentation or fracture of the Ozurdex implant observed immediately after routine intravitreal implantation for macular oedema.
In two patients receiving intravitreal Ozurdex implant injection, a rare complication of fracture of implant was noted immediately after the injection. No additional complication was noted in either of the patients. On follow-up, the macular oedema had resolved and there were no further complications.
We shared our experience with the manufacturer, and it was confirmed that, during the normal degradation process, the implant may become soft and break into pieces. Allergan shared their unpublished data on in vivo and in vitro drug release profile of one piece versus three pieces of implant, which is presented in this case report.
With more and more microsurgical implantation procedures, clinicians should be well aware of these unusual although rare complications. Even though the desegmented implants do not appear to cause more intraocular complications compared with single-piece implants, patients with defragmented implants should be followed up carefully to monitor for unexpected complications.
报告两例奥扎格雷(Ozurdex)植入物分离或断裂的病例,这些病例是在常规玻璃体内注射治疗黄斑水肿后立即观察到的。
在接受玻璃体内奥扎格雷植入物注射的两名患者中,在注射后立即发现了植入物骨折的罕见并发症。两名患者均未出现其他并发症。随访时,黄斑水肿已消退,无进一步并发症。
我们与制造商分享了我们的经验,制造商确认在正常降解过程中,植入物可能会变软并断裂成碎片。艾尔建(Allergan)公司分享了他们关于一片与三片植入物的体内和体外药物释放情况的未公开数据,本病例报告对此进行了介绍。
随着越来越多的微创手术植入程序,临床医生应该充分了解这些虽然罕见但不常见的并发症。尽管与单一片段植入物相比,分离的植入物似乎不会引起更多的眼内并发症,但应仔细随访有碎片的植入物患者,以监测是否有意外并发症。