Diago Teresa, Fau Silvia G, Roca Jaime Moya
Unit of Macula. Department of Ophthalmology, Hospital de La Ribera, Alzira, Valencia, Spain.
Eur J Ophthalmol. 2023 May;33(3):1501-1505. doi: 10.1177/11206721221151136. Epub 2023 Jan 11.
To show an alternative surgical technique for the introduction of the intravitreal fluocinolone acetonide (FAc) implant (Iluvien) into the vitreous cavity using a 23-gauge (G) trocar if it is retained during its implantation in the subconjunctival space.
We describe the surgical procedure performed to solve the complication: The FAc implant was extracted from the subconjunctival space using flat retinal forceps. A 23-G trocar was inserted 3,5 mm to the limbus. The same flat retinal forceps were used to take the FAc implant and introduce it into the vitreous cavity using a 23-G trocar.
The patient's best corrected visual acuity (BCVA) (Snellen) improved from 20/200 to 20/63 and the central macular thickness (CMT) was reduced from 610 microns (µm) to 215 µm after one week of the FAc implantation. He remained stable after 3 months of follow-up, with a BCVA of 20/63 and a CMT of 191 µm. His intraocular pressure (IOP) remained stable and the integrity of the implant was checked by indirect ophthalmoscopy.
The introduction of the intravitreal FAc implant using a 23-gauge trocar constitutes a valid alternative if it is retained during its implantation in the subconjunctival space.The functionality of the implant remained intact in our patient.
展示一种替代手术技术，即在玻璃体内注射曲安奈德（FAc）植入物（Iluvien）植入结膜下间隙时若其滞留，如何使用23号（G）套管针将其引入玻璃体腔。
我们描述了为解决该并发症所进行的手术步骤：使用扁平视网膜镊从结膜下间隙取出FAc植入物。在角膜缘3.5 mm处插入23G套管针。使用同一把扁平视网膜镊夹取FAc植入物，并通过23G套管针将其引入玻璃体腔。
FAc植入一周后，患者的最佳矫正视力（BCVA）（Snellen）从20/200提高到20/63，中心黄斑厚度（CMT）从610微米（µm）降至215 µm。随访3个月后情况保持稳定，BCVA为20/63，CMT为191 µm。其眼压（IOP）保持稳定，通过间接检眼镜检查植入物的完整性。
如果玻璃体内FAc植入物在植入结膜下间隙时滞留，使用23号套管针将其引入玻璃体腔是一种有效的替代方法。在我们的患者中，植入物的功能保持完好。
