Management of fluocinolone implant dissociation during implant exchange.

Abstract

Three patients with chronic, noninfectious uveitis requiring immunosuppressive therapy underwent fluocinolone acetonide (FA) implant exchange complicated by dissociation of the medication reservoir from its anchoring strut. In 2 patients, the medication reservoir descended into the vitreous cavity and required pars plana vitrectomy with intraocular foreign body removal techniques for its retrieval. The use of viscoelastic or perfluorocarbon to elevate the device was helpful in the safe removal of the FA implant device. Surgeons performing FA implant exchange should be aware of this potential complication and anticipate the possible need for vitreoretinal instrumentation and personnel. Patients undergoing FA explantation or exchange should be counseled regarding this potential complication prior to surgery.

• Authors: Steven Yeh, Colleen M Cebulla, S Robert Witherspoon, Geoffrey G Emerson, M Vaughn Emerson, Eric B Suhler, Thomas A Albini, Christina J Flaxel
• Journal: Archives of ophthalmology (Chicago, Ill. : 1960) (Arch Ophthalmol) Vol. 127 Issue 9 Pg. 1218-21 (Sep 2009) ISSN: 1538-3601 [Electronic] United States
• PMID: 19752436 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Drug Implants
• Fluocinolone Acetonide

Topics

• Adult
• Anti-Inflammatory Agents
• Chronic Disease
• Drug Implants (adverse effects)
• Eye Foreign Bodies (etiology, surgery)
• Female
• Fluocinolone Acetonide
• Foreign-Body Migration (etiology, surgery)
• Humans
• Male
• Middle Aged
• Ophthalmologic Surgical Procedures
• Retreatment
• Retrospective Studies
• Uveitis (drug therapy)
• Vitrectomy