Cervantes Andrés Lisker, Crim Nicolás, García-Arroyo Santiago, Morales-Cantón Virgilio, Montoya Raúl Velez
Retina Department, Asociación para Evitar la Ceguera en México, Hospital Dr. Luis Sanchez Bulnes, Mexico City, Mexico.
Cataract Department, Asociación para Evitar la Ceguera en México, Hospital Dr. Luis Sanchez Bulnes, Mexico City, Mexico.
Arq Bras Oftalmol. 2020 Jun;83(3):246-249. doi: 10.5935/0004-2749.20200066. Epub 2020 May 29.
The intravitreal dexamethasone implant is a sustained-release anti-inflammatory drug system that releases 0.7 mg of dexamethasone into the vitreous cavity. The following case report describes a rare complication: accidental injection of the dexamethasone implant into the crystalline lens. A 73-year-old woman was diagnosed with central retina vein occlusion and cystoid macular edema. Initial tSreatment included three monthly intravitreal doses of anti-vascular endothelial growth factor treatment, which was not successful. Treatment was then modified to an intravitreal dexamethasone implant. Ten weeks later, the implant was observed in the posterior cortex of the crystalline lens. Because no improvement had occurred, the patient underwent phacoemulsification surgery, during which part of the lens migrated into the vitreous cavity. Therefore, 23-gauge pars plana complete vitrectomy was performed with trans-surgical administration of intravitreal aflibercept. Crystalline lens injury due to an intravitreal dexamethasone implant is a rare complication and typically results from the injection procedure. Immediate surgical or conservative approaches should be considered on an individual basis.
玻璃体内地塞米松植入物是一种缓释抗炎药物系统，可向玻璃体腔释放0.7毫克地塞米松。以下病例报告描述了一种罕见的并发症：地塞米松植入物意外注入晶状体。一名73岁女性被诊断为视网膜中央静脉阻塞和黄斑囊样水肿。初始治疗包括每月三次玻璃体内注射抗血管内皮生长因子治疗，但未成功。随后治疗改为玻璃体内植入地塞米松。十周后，在晶状体后皮质观察到植入物。由于病情未改善，患者接受了白内障超声乳化手术，术中部分晶状体移入玻璃体腔。因此，进行了23G经平坦部全玻璃体切除术，并经手术给予玻璃体内阿柏西普。玻璃体内地塞米松植入物导致的晶状体损伤是一种罕见并发症，通常由注射操作引起。应根据个体情况考虑立即采取手术或保守治疗方法。
