Anti-infectives. For those physicians who have not yet implanted the dexamethasone intravitreal implant, I would suggest that they use povidone-iodine prior to the injection. Regarding the use of antibiotics, I would also advise skepticism toward small studies that show any kind of reduction or increase in rates of endophthalmitis as a result of the use of a particular antibiotic.

Reinjections. In my practice, the greatest number of reinjections with the dexamethasone intravitreal implant was three (not including the initial implant). This patient had a central retinal vein occlusion with severe edema, and the first injection of the implant elicited minimal response. The patient continued to progress with each subsequent injection of the dexamethasone implant. This case demonstrates that there is a lack of information regarding the effects of the implant injected sequentially for an extended period of time. Additionally, this case shows that retinal vein occlusion is a diverse disease with a variable response to treatment. Outcomes with the dexamethasone intravitreal implant are, in my opinion, patient-dependent.