['To characterize spontaneous dislocation of the fluocinolone acetonide sustained release implant (Retisert; Bausch & Lomb) drug pellet from its strut.', 'Retrospective, observational case series.', 'The medical records of 224 patients in whom 407 fluocinolone acetonide implants were placed by either of 2 surgeons between 1998 and 2012 were reviewed for drug pellet-suture strut separation, observed before surgery in clinic or occurring at the time of implant replacement.', 'Seventeen (4.2%) of 407 drug pellets spontaneously dislocated away from the suture strut at a mean postimplantation time of 77.4 months (range, 33 to 132 months). The rate of spontaneous dislocation increased from 1 dislocation per 262 person years (95% confidence interval, 1 per 1269 to 1 per 89.6 person-years) before 60 months to 1 dislocation per 13.3 person-years (95% confidence interval, 1 per 24.4 to 1 per 7.9 person-years) afterward. Fourteen of 17 dislocated pellets were removed surgically. Of 77 exchanged fluocinolone acetonide implants without dislocated pellets, 11 (14.2%) pellets had separated, but not dislocated away, from the strut; time to exchange of dislocated or dissociated pellets was significantly longer than time to exchange of intact fluocinolone acetonide implants (70.5 vs 44.9 months; P < .001).'] Do spontaneous dislocation of fluocinolone acetonide implant pellets from their suture struts?