Accidental injections of dexamethasone intravitreal implant (Ozurdex®) into the crystalline lens

Purpose: To describe the side effects and management after inadvertent injection of a dexamethasone implant (Ozurdex (R)) into the crystalline lens. Methods: Two case reports. Results: Two patients with macular edema due to unilateral retinal vein occlusion were scheduled for an intravitreal injection of Ozurdex (R). During the procedure, the implant was accidentally injected into the crystalline lens. Both patients developed cataracts during the course of several weeks and in both there was an intraocular pressure (IOP) increase, which required treatment with topical hypotensives. Macular edema improved only slightly. Cataract surgery with uneventful removal of the implant was performed 3 (case 1) and 6 months (case 2) after the injection. Conclusions: After inadvertent injection of Ozurdex (R) into the crystalline lens, cataract surgery with removal of the implant should be performed as soon as possible in order to avoid IOP increase and so that the underlying condition may be treated adequately.