Successful management of intralenticular Ozurdex injection causing cataract and intractable glaucoma

  • Kalpa Negiloni sankara nethralaya medical research foundation
  • Ronnie Jacob George
  • Sridharan Sudharshan
  • Shwetha Tripathi
Keywords: glaucoma, intravitreal corticosteroid implant, intralenticular Ozurdex, Ozurdex, posterior uveitis


A 50-year-old female presented with profound vision loss and was previously advised injection Ozurdex in the left eye. In the left eye, the anterior chamber was quiet, intraocular pressure (IOP) was 58 mmHg and cataractous changes were noted with Ozurdex implant inside the lens substance. The left eye had glaucomatous cupping (0.9:1 CDR), bipolar rim thinning, inferior notch and healed choroiditis. The patient underwent phacoemulsification, trabeculectomy and mitomycin-C in the left eye. Visual acuity improved and IOP was under control. Although Ozurdex is effective, there are reports of complications related to the drug and implantation procedure. This case highlights an uncommon complication of an uncontrolled, persistent steroid response leading to glaucomatous optic atrophy and profound vision loss due to an accidental intralenticular implantation of Ozurdex. Our case reinforces the need for caution about the decision regarding the judicious use of intravitreal steroids and employment of appropriate technique.


Ozurdex® (Allergan, Inc, Irvine, CA, USA). Last accessed 15 January 2018.

Haller JA, Kuppermann BD, Blumenkranz MS, et al. Dexamethasone DDS phase II study group. Randomized controlled trial of an intravitreous dexamethasone drug delivery system in patients with diabetic macular edema. Arch Ophthalmol. 2010;128(3):289-296.

Myung JS, Aaker GD, Kiss S. Treatment of noninfectious posterior uveitis with dexamethasone intravitreal implant. Clin Ophthalmol. 2010;4:1423-1426.

Ghosn CR, Li Y, Orilla WC, et al. Treatment of experimental anterior and intermediate uveitis by a dexamethasone intravitreal implant. Invest Ophthalmol Vis Sci. 2011;52(6):2917-2923.

Sekeroglu MA, Anayol MA, Koc F, Tirhis H, Ozkan SS, Yilmazbas P. Intralenticular sustainedrelease dexamethasone implant: is it still effective on macular edema. Case Rep Ophthalmol. 2016;7(1):85-89.

Coca-Robinot J, Casco-Silva B, Armadβ-Maresca F, García-Martínez J. Accidental injections of dexamethasone intravitreal implant (Ozurdex) into the crystalline lens. Eur J Ophthalmol. 2014;24:633-636.

Fasce F, Battaglia Parodi M, Knutsson KA, et al. Accidental injection of dexamethasone intravitreal implant in the crystalline lens. Acta Ophthalmol. 2014;92:e330, e331.

Ram J, Agarwal AK, Gupta A, Gupta A. Phacoemulsification and intraocular lens implantation after inadvertent intracapsular injection of intravitreal dexamethasone implant. BMJ Case Rep. 2012;12:2012.

Sheen OS, Gepstein R, Assia EI. Intralenticular Ozurdex implant: a case report. Clin Surg. 2017;2:1556.

Munteanu M, Rosca C. Repositioning and follow-up of intralenticular dexamethasone implant. J Cataract Refract Surg. 2013;39:1271-1274.

Roy R, Hegde S. Split Ozurdex implant: a caution. Can J Ophthalmol. 2013;48(1):e15, e16.

Chang-Lin JE, Attar M, Acheampong AA, et al. Pharmacokinetics and pharmacodynamics of a sustained-release dexamethasone intravitreal implant. Invest Ophthalmol Vis Sci. 2011;5;52(1):80-86.

How to Cite
Negiloni, K., George, R., Sudharshan, S., & Tripathi, S. (2020). Successful management of intralenticular Ozurdex injection causing cataract and intractable glaucoma. Asian Journal of Ophthalmology, 17(2), 216-221.
Case Reports/Case Series