First Author: M.Raimundo PORTUGAL
Co Author(s): S. Marques M. Guerra F. Henriques
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To report the case of a fifty-one-year-old man with right cystoid macular edema (CME) following superior branch retinal vein occlusion that presented to our institution with a dexamethasone intravitreal implant lodged in the lens.
Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra - CHUC, Coimbra, Portugal.
Preoperative best-corrected visual acuity was 20/400. After a full ophthalmological exam, optical biometry and SD-OCT the patient underwent surgery. The surgery was initiated by continuous capsulorhexis, hydrodelineation and phacophagia of the lens with the I&A (irrigation and aspiration) handpiece. To prevent accidental aspiration of the dexamethasone implant, its fragments were temporarily moved to the iridocorneal angle using viscoelastic. This was followed by 23G pars plana vitrectomy and endophotocoagulation of the ischemic retinal quadrant. The dexamethasone implant fragments were then moved to vitreous cavity through the already torn posterior capsule. Finally, a 3-piece IOL was inserted in the ciliary sulcus.
The immediate post-operative period was uneventful. Ten days after surgery, best-corrected visual acuity was 20/50 with marked improvement of CME.
By using a creative approach, it was possible to simultaneously solve the complication (cataract surgery and IOL insertion) and salvage the implant (moved back to the vitreous cavity), obtaining an excellent early postoperative anatomical and functional result.