Use of a High Infusion Rate to Prevent Posterior Dislocation of Fluocinolone Acetonide Implant during Surgical Removal

Abstract

Purpose: To describe a strategy for reducing the risk of posterior dislocation of a fluocinolone implant during exchange or removal.

Design: Case report and in vitro model.

Methods: Description of a surgical case and an in vitro experiment evaluating the role of infusion pressure in maintaining implant stability in surgery.

Results: Use of an elevated infusion pressure allowed safe removal of a fluocinolone implant that spontaneously dissociated into two pieces during removal. An in vitro model using the implant’s drug reservoir in a cadaver eye demonstrated that the implant remained in a stable location at the scleral incision if the infusion pressure was high, whereas with a lower infusion pressure the implant spontaneously fell onto the posterior pole of the eye.

Conclusions: During exchange or removal of a fluocinolone implant, an elevated infusion pressure may reduce the risk of posterior dislocation of the device.

Keywords:

• dissociation
• exchange
• fluocinolone implant
• infusion pressure
• uveitis

ACKNOWLEDGMENT

This work was supported by Research to Prevent Blindness and That Man May See, Inc.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.