Suture loop to aid in ganciclovir implant removal.
BACKGROUND
The ganciclovir implant (Vitrasert; Bausch & Lomb Inc, Claremont, Calif) has been a useful device in the management of cytomegalovirus retinitis. Seven months after placement, implant exchange is often considered. However, removal may be difficult and may result in vitreous hemorrhage or intraocular dislocation.


OBJECTIVE
To describe a suture loop attached to the implant strut and left in the sub-Tenon space to aid in implant removal.


METHODS
Twenty-five eyes of 17 patients received a ganciclovir implant with an 8-0 nylon suture loop left beneath the Tenon capsule and underwent at least 6 months of follow-up. Two of these eyes subsequently had a similarly modified ganciclovir implant placed at a separate site (inferonasally) with at least 6 additional months of follow-up. Six eyes of 3 patients had the implant removed as part of an exchange and underwent at least 4 months of follow-up.


RESULTS
In the 25 eyes, there were no cases of endophthalmitis, wound leak, suture exposure, or other complications. At implant removal in the 6 eyes previously mentioned, the loop was used for traction on the implant and aided in localization of the implant strut. In these 6 eyes, there were no cases of retinal or choroidal detachment, visually significant vitreous hemorrhage, implant dislocation, or other complications.


CONCLUSIONS
A sub-Tenon capsule suture loop is well tolerated and can assist in ganciclovir implant removal.
MacCumber
M W
MW
Department of Ophthalmology, Rush Medical College, Rush University, Chicago, Ill 60612, USA. macretina@aol.com
Sadeghi
S
S
Cohen
J A
JA
Deutsch
T A
TA
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003238:Connective Tissue / Q000601:surgery; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D004343:Drug Implants; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009757:Nylons; D013508:Ophthalmologic Surgical Procedures; D012590:Sclera / Q000601:surgery; D013536:Suture Techniques; D013537:Sutures
D000998:Antiviral Agents; D004343:Drug Implants; D009757:Nylons; D015774:Ganciclovir