Iatrogenic crystalline lens injury during intravitreal injection of triamcinolone acetonide: A report of two cases  

作　　者：Jing Su Li-Jun Zheng Xin-Quan Liu 

机构地区：[1]Department of Ophthalmology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China [2]Department of General Surgery,Shanghai Tenth People’s Hospital,Tongji University,Shanghai 200072,China

出　　处：《World Journal of Clinical Cases》2019年第22期3784-3791,共8页世界临床病例杂志

基　　金：Supported by Scientific Research Projects of Shanghai Municipal Health and Family Planning Commission,No.201640049

摘　　要：BACKGROUND Intravitreal injection has become an efficient approach for delivering drugs at therapeutic levels to the posterior segment in retinal diseases.However,the increased frequency and number of intravitreal injections have raised concerns about their side effects.As manipulation during surgery is relatively simple,details of the procedure are easily overlooked.Iatrogenic crystalline lens injury is a rare complication caused by improper manipulation during surgical procedures.We report two cases of crystalline lens injury during intravitreal injection of triamcinolone acetonide(TA)with the hope of providing an insight into this treatment.CASE SUMMARY Case 1 was a 62-year-old woman with macular edema caused by central retinal vein occlusion in her right eye,and Case 2 was a 65-year-old man with macular edema caused by branch retinal vein occlusion in his right eye.In view of the patients’condition and economic constraints,an intravitreal injection of TA was administered.Due to inappropriate manipulation during surgery,the lens was injured.The site of lens injury and clinical manifestations were different in the two cases.Symptomatic treatment and continuous follow-up were carried out.The therapeutic effect following phacoemulsification of the cataract was satisfactory.CONCLUSION Well-defined surgical incision under proper anesthesia,sufficient patient information and proficient anatomical skills of the physician are mandatory to prevent this rare adverse event.Careful and meticulous phacoemulsification of the cataract is suggested.BACKGROUND Intravitreal injection has become an efficient approach for delivering drugs at therapeutic levels to the posterior segment in retinal diseases. However, the increased frequency and number of intravitreal injections have raised concerns about their side effects. As manipulation during surgery is relatively simple,details of the procedure are easily overlooked. Iatrogenic crystalline lens injury is a rare complication caused by improper manipulation during surgical procedures. We report two cases of crystalline lens injury during intravitreal injection of triamcinolone acetonide(TA) with the hope of providing an insight into this treatment.CASE SUMMARY Case 1 was a 62-year-old woman with macular edema caused by central retinal vein occlusion in her right eye, and Case 2 was a 65-year-old man with macular edema caused by branch retinal vein occlusion in his right eye. In view of the patients’ condition and economic constraints, an intravitreal injection of TA was administered. Due to inappropriate manipulation during surgery, the lens was injured. The site of lens injury and clinical manifestations were different in the two cases. Symptomatic treatment and continuous follow-up were carried out.The therapeutic effect following phacoemulsification of the cataract was satisfactory.CONCLUSION Well-defined surgical incision under proper anesthesia, sufficient patient information and proficient anatomical skills of the physician are mandatory to prevent this rare adverse event. Careful and meticulous phacoemulsification of the cataract is suggested.

关 键 词：CRYSTALLINE lens INTRAVITREAL injection TRIAMCINOLONE ACETONIDE Iatrogenicinjury Case REPORT 

分 类 号：R73[医药卫生—肿瘤]