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Levent Akduman, Lyndell L. Lim, Ebru N. Cetin, Jamie Levy; Spontaneous Separation of Pellet into the Vitreous: A Late Complication of Retisert® Implant. Invest. Ophthalmol. Vis. Sci. 2012;53(14):509.
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Separation of the Retisert® pellet from its strut during exchange or removal of the implant has previously been reported. We report two cases of spontaneous pellet separation as a late term complication, and successful removal with vitrectomy.
Two patients with chronic intermediate uveitis implanted with Retisert®, who later had spontaneous pellet dissociation, are described.
Both patients had Retisert® implanted 5.5 years previously. Their presenting symptom was of a sudden, central "huge" floater. Clinical examination revealed a dissociated Retisert® pellet floating in the vitreous, and in one case resultant retinal commotio and a retinal tear. Pellets were removed via a pars plana vitrectomy with a large sclerotomy. The retinal tear in the second case was treated with laser photocoagulation. Both cases recovered successful vision without further complications.
Spontaneous pellet separation may occur with Retisert® implants as a late complication, where retinal tears may also occur as a result of the loose pellet. Although both of these spontaneous dislocations and other cases of pellet dislocation during exchange or removal of the implant have involved early versions of the Retisert® implant, it is yet to be determined whether these dislocations have been the result of an initial manufacturing fault, or are related to their extended intraocular exposure.
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