Modified insertion technique for a sustained-release dexamethasone intravitreal implant (Ozurdex®)

Abstract

Purpose: We describe a modified injection technique that adheres a sustained-release dexamethasone intravitreal implant (Ozurdex®) to the vitreous base. Observations: This modified technique was applied after removal of a prior dislocated Ozurdex® that migrated into the anterior chamber in one patient, and also on another patient bothered by perception of a large floater induced by a free-floating Ozurdex® in the vitreous cavity previously inserted with the conventional technique. The main feature of this new technique consisted of altering the conventional “bevel-up” orientation of the insertion needle tip towards the vitreous cavity to the modified “bevel-down” orientation of the needle tip directed towards the pars plana and vitreous base, for the purpose of adhering a portion of or the entire dexamethasone implant to the vitreous base. Neither patient developed postoperative complications with this technique. Conclusions and importance: This modified insertion technique allows adherence of Ozurdex® to the vitreous base and avoids adverse effects associated with a free-floating Ozurdex®, such as its migration into the anterior chamber, or visual disturbance associated with movement of the implant.

Keywords

• Sustained-release dexamethasone
• Intravitreal injection
• Intravitreal implant
• Dislocation dexamethasone implant into anterior chamber
• Modified insertion technique
• Cystoid macular edema