title: 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.affiliation: Department of Ophthalmology, Casey Eye Institute, Oregon Health Sciences University, Portland, Oregon 97239, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Yeh
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Cebulla
authors.forename: S Robert
authors.initials: SR
authors.lastname: Witherspoon
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Emerson
authors.forename: M Vaughn
authors.initials: MV
authors.lastname: Emerson
authors.forename: Eric B
authors.initials: EB
authors.lastname: Suhler
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Albini
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Flaxel
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents; D002908:Chronic Disease; D004343:Drug Implants / Q000009:adverse effects*; D005129:Eye Foreign Bodies / Q000209:etiology / Q000601:surgery*; D005260:Female; D005446:Fluocinolone Acetonide; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D019233:Retreatment; D012189:Retrospective Studies; D014605:Uveitis / Q000188:drug therapy*; D014821:Vitrectomy
chemical_list: D000893:Anti-Inflammatory Agents; D004343:Drug Implants; D005446:Fluocinolone Acetonide