A rare complication of intravitreal dexamethasone implantation: Intralenticular Ozurdex implantation

Intravitreal dexamethasone (DEX) implant is a device that continuously releases DEX after injection into the vitreous. It is used for indications such as diabetic macular edema (DME), non-infectious posterior uveitis, and retinal vein occlusion. The most common complications include intraocular pressure elevation and cataract. We present the case of a 59-year-old female referred for cataract surgery 18 months after receiving a DEX implant for DME. Slit-lamp biomicroscopy revealed a Grade III nuclear cataract and an intralenticular DEX implant. The patient subsequently underwent phacoemulsification with intraocular lens (IOL) implantation. Hydrodissection was deliberately omitted, and excessive manipulations were avoided. The posterior capsule remained intact, and a three-piece IOL was implanted within the capsular bag without intraoperative complications. Conclusion: Intralenticular Ozurdex implantation is a rare but clinically relevant complication. Careful injection technique, patient cooperation, and meticulous surgical management are essential to prevent and successfully manage this event.
 

Keywords: Diabetes, implantation, intralenticular, Ozurdex