SMALL-GAUGE TECHNIQUES FOR REMOVING A FLUOCINOLONE ACETONIDE IMPLANT

Area of Science:

• Ophthalmology
• Retinal Surgery
• Drug Delivery Systems

Background:

• Long-acting injectable fluocinolone implants are utilized in clinical settings.
• Situations may necessitate the removal of these intraocular implants.
• Standard explantation techniques for these devices are not well-established.

Purpose of the Study:

• To describe potential explantation techniques for fluocinolone implants.
• To assess the safety and feasibility of removing these implants via standard sclerotomy or vitrectomy systems.

Main Methods:

• A porcine eye model was employed to simulate vitreoretinal surgery.
• Fluocinolone implants were injected into the vitreous cavity.
• Explantation was performed using 23-Gauge and 25-Gauge vitrectomy systems and forceps, with subsequent examination of implant integrity. Elimination via a vitrector system was also tested.

Main Results:

• Implants were successfully removed through both 23-G and 25-G vitrectomy cannulas with only minor structural damage.
• Removal through the 25-G sclerotomy occasionally dislodged the cannula with the implant.
• Elimination of implants using a low-cut rate vitrector system was feasible with both 23-G and 25-G systems.

Conclusions:

• Standard 23-G or 25-G vitrectomy systems can be used for the safe removal of fluocinolone implants.
• The impact of intraocular manipulation on drug delivery pharmacokinetics, if the implant is not explanted, remains undetermined.