Use of a high infusion rate to prevent posterior dislocation of fluocinolone acetonide implant during surgical removal.

PURPOSE: To describe a strategy for reducing the risk of posterior dislocation of a fluocinolone implant during exchange or removal.
DESIGN: Case report and in vitro model.
METHODS: Description of a surgical case and an in vitro experiment evaluating the role of infusion pressure in maintaining implant stability in surgery.
RESULTS: Use of an elevated infusion pressure allowed safe removal of a fluocinolone implant that spontaneously dissociated into two pieces during removal. An in vitro model using the implant's drug reservoir in a cadaver eye demonstrated that the implant remained in a stable location at the scleral incision if the infusion pressure was high, whereas with a lower infusion pressure the implant spontaneously fell onto the posterior pole of the eye.
CONCLUSIONS: During exchange or removal of a fluocinolone implant, an elevated infusion pressure may reduce the risk of posterior dislocation of the device.