PMC5352935_01
(a) Intra-operative photograph showing opacified vitreous and the 23-gauge vitreous cutter engaging the dexamethasone (DEX) implant. The cutter was unable to remove the implant. (b) The implant was lifted using the cutter and removed using a 23-gauge intravitreal forceps. (c) The remaining fragment did not fit into a 23-gauge intravitreal forceps, and could be removed only with a 20-gauge intravitreal forceps. (d) Two more fractured pieces of the DEX implant were found on indentation. These were removed using intravitreal forceps after meticulous vitreous dissection.
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The vitreous was opacified and the fractured implant was present inferiorly (Fig.1a). Following complete vitrectomy, the implant was lifted using the suction mode of the vitreous cutter, grasped with a 23 gauge forceps (Fig.1b) and removed. After dissection in this area, it was removed using a 20 gauge forceps (Fig.1c). Two smaller fragments were seen on indentation (Fig.1d) and carefully dissected and removed.
(a) Fundus photograph at the final follow-up of 3 months showing clear media and hard exudates at the macula. (b) Spectral domain optical coherence tomography demonstrating mild macular edema with hard exudates.
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At the final follow-up of 3 months, BCVA was 20/60 with no evidence of any inflammation (Fig.2a), or ERM on OCT (Fig.2b).