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SC Patel, RA P deCarvalho, BD Kuppermann; Surgical Management of Posteriorly Dislocated Ganciclovir Implants . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3526.
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Purpose:To describe the surgical management of dislocated intraocular ganciclovir implants in patients with cytomegalovirus retinitis. Methods:Review of surgical techniques in removing dislocated ganciclovir implants in 7 patients. Results:Dislocation of implants occurred at a mean of 3 years after placement. Ganciclovir implants have traditionally been placed with an 8-0 nylon suture which loses tensile strength over time. In cases with limited fibrosis of the strut with the sclera, dislocation of the implants has recently been described. Due to the solid nature of these non-biodegradable implants, the removal of dislocated ganciclovir implants can have potential complications. In this series, severe macular damage happened in one case secondary to intraocular implant manipulation. This type of complication was prevented in the other cases by a modification of the surgical technique. Prevention of fluid fluxes by limiting the sclerotomy size to 20 gauge until the implant is grasped, use of perfluorocarbon liquid and suction-assisted manipulation of the implant showed to be essential in minimizing the risk of traumatic retinal complications. There were no cases complicated by lens touch, peripheral retinal tears or vitreous hemorrhage. Conclusion:Dislocation of ganciclovir implants is a rare event. The removal of these implants can lead to both intraoperative and postoperative complications. However, with the proper technique, these ganciclovir implants can be removed with good postoperative outcomes.
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