Successful perfluorocarbon-assisted retrieval of a subretinal dexamethasone implant during retinal detachment repair

Iatrogenic subretinal injection of dexamethasone implants is rare and has been reported in eyes without retinal detachment. We describe the surgical management and successful perfluorocarbon-assisted retrieval of a subretinal dexamethasone implant in the setting of retinal detachment. A 63-year-old man with type 2 diabetes mellitus, proliferative diabetic retinopathy, and diabetic macular edema with prior dexamethasone implants presented with a rhegmatogenous retinal detachment in the left eye. Preoperative examination identified a dexamethasone implant in the subretinal space. During pars plana vitrectomy, the implant migrated into the vitreous cavity and was removed using a perfluorocarbon-assisted bimanual technique, followed by standard retinal detachment repair with gas tamponade. The implant was successfully removed, and retinal reattachment was achieved. Subretinal migration of a dexamethasone implant is a rare complication associated with retinal detachment and intraoperative challenges. Perfluorocarbon-assisted bimanual removal is effective, and careful preinjection retinal evaluation with meticulous injection technique is essential to minimize risk.