Nonpharmacological aspects of intravitreal dexamethasone implant injections: A Retrospective Study of 3,430 Injections and Complications

Abstract

Purpose:This study aims to evaluate the nonpharmacological safety profile of intravitreal dexamethasone implants in cases with different etiologies.Methods:This retrospective university-based study analyzed clinical reports of patients receiving 0.7 mg dexamethasone implant injections between 2013 and 2023. The study recorded patient demographics, injection indications, and follow-up data. Complications caused by the injection procedure and adverse events other than pharmacological side effects within a 3-month period were included.Results:In this study, 3,430 dexamethasone implant injections were made into 1,471 eyes of 1,091 patients. Nonpharmacological complications developed in 611 injections (17.8%). Subconjunctival hemorrhage was noted as the leading nonpharmacological complication (n = 576, 16.8%). Sight-threatening 35 nonpharmacological adverse events and complications (1.0%) were recorded. Cases of anterior chamber migration, vitreous hemorrhage, retinal detachment, endophthalmitis, hypotony, and implant misplacement were observed. Cases requiring intensive treatments and additional surgical interventions were encountered.Conclusion:The injection of the dexamethasone implant may lead to nonpharmacological complications caused by the mechanical impact of the injection or improper positioning of the implant, potentially resulting in vision loss. Severe outcomes such as corneal decompensation, retinal detachment, and endophthalmitis can ensue, emphasizing the gravity of these complications. Careful selection of patients and adherence to proper injection techniques are essential in reducing these risks.