Nguyen Thi Lyly, Wolfensberger Thomas J
Department of Ophthalmology - University of Lausanne, Hôpital Ophtalmique Jules-Gonin, Lausanne, Switzerland.
Klin Monbl Augenheilkd. 2019 Apr;236(4):412-414. doi: 10.1055/a-0808-1847. Epub 2019 Jan 7.
To characterise the surgical removal technique of a dislocated dexamethasone implant in the anterior chamber and to gauge its success by analysing corneal transparency and subsequent visual acuity recovery in the postoperative phase.
Description of a patient who presented with an anterior chamber dexamethasone implant migration through an inferior iridotomy performed previously for a silicone oil fill in aphakia. Visual acuity had dropped to counting fingers due to marked corneal oedema.
The implant was removed using a 23-g needle aligned with the axis of the implant through a paracentesis. After the clinical follow-up at 2 months, best-corrected visual acuity had returned to 0.2, which remained stable at the last follow-up at 14 months with an intraocular pressure of 10 mmHg. The corneal oedema resolved completely.
This novel surgical management of a dexamethasone implant dislocation into the anterior chamber was successful and resulted in no long-term corneal damage when the implant was removed without delay. A repeated Ozurdex injection in patients with previous inferior iridotomy may require prior suturing of the iridotomy.
描述前房内脱位的地塞米松植入物的手术取出技术，并通过分析术后角膜透明度和随后的视力恢复情况来评估其成功率。
描述一名患者，其前房地塞米松植入物通过先前为无晶状体眼硅油填充而进行的下方虹膜切开术发生移位。由于明显的角膜水肿，视力已降至数指。
通过穿刺术，使用与植入物轴线对齐的23G针头取出植入物。在2个月的临床随访后，最佳矫正视力恢复到0.2，在14个月的最后随访时保持稳定，眼压为10 mmHg。角膜水肿完全消退。
这种处理前房内脱位地塞米松植入物的新型手术方法是成功的，并且在及时取出植入物时不会造成长期角膜损伤。对于先前有下方虹膜切开术的患者，重复注射Ozurdex可能需要先缝合虹膜切开术。
