Vitreous pillow for sustained-release intravitreous drug delivery implants

Background and Objective: Intravitreous drug delivery systems are injected or surgically implanted for sustained release of drugs to the posterior segment for conditions such as vein occlusions and diabetic macular edema. Since these devices rely upon the vitreous body for support, concerns regarding their migration and prolonged direct retinal contact have limited their use in vitrectomized eyes. Patients and Methods: Three patients with persistent macular edema received dexamethasone intravitreal implantation following vitrectomy employing the authors' novel technique for embedding the system in a residual inferior vitreous skirt that serves as a pillow on which the implant rests after pars plana vitrectomy. Results: At minimum 6-month follow-up, all patients had improved visual acuity and improved central retinal thickness on optical coherence tomography, were without complaints of floaters or migration of the implant, and were without complications. The implant consistently remained embedded in the inferior vitreous skirt. Conclusion: The technique may mitigate concerns regarding implant migration and direct retina contact.