Corneal toxicity after Ozurdex® migration into anterior chamber

Bernal, Lucas Ribé; Estévez, Benito Vilas

doi:10.1016/j.oftale.2016.04.013

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…Pseudophakia, [6][7][8][9][10] including posterior chamber intraocular lenses (PCIOL), anterior chamber intraocular lenses (ACIOL), 11,12 sulcus intraocular lenses, iris-fixated lenses, [5][6][7]13,14 scleral-fixated lenses, 12,[15][16][17][18][19] and glued IOLs, 20 have all been reported in cases of implant migration. Aphakia, 5,[21][22][23][24][25][26] prior iridectomies, 6,12,20,26,27 congenital iris coloboma, 10 posterior capsule violation during prior surgeries or following posterior capsulotomies, 5,7,13,27 and weak zonules 9,28 are other features frequently noted in these cases. Other alterations to the natural lens or iris anatomy may place patients at higher risk of implant migration due to the presence of additional pathways for the implant to travel.…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone implant migration in an eye with congenital glaucoma: A case report and review of the literature

Chang

Peter

et al. 2021

European Journal of Ophthalmology

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Introduction: The dexamethasone (DEX) implant is an FDA approved treatment for diabetic macular edema, non-infectious posterior uveitis, and macular edema secondary to branch or central retinal vein occlusions. We describe a case of anterior chamber (AC) migration of a DEX implant in a patient with a history of congenital glaucoma and perform a review of the literature on this particular complication, summarizing the common risk factors, subsequent complications, and management options. Case description: A 46-year-old female with a history of congenital glaucoma, status post cataract extraction with insertion of intraocular lens, pars plana vitrectomy, and Baerveldt tube implant in the left eye was referred for post-operative cystoid macular edema (CME). The patient underwent insertion of a DEX implant, resulting in improvement in her CME. After the fourth implant was injected, the patient noticed a white line in her eye while looking in the mirror after doing jumping jacks. Slit lamp examination confirmed migration of the implant into the AC. Ultimately, the patient was taken to the operating room, where her implant was removed via bimanual vitrectomy through an anterior approach. Conclusion: This case report and literature review explores the ophthalmic structural changes specific to congenital glaucoma which may have predisposed this eye to anterior migration of the DEX implant. The purpose of this review is to detail the anatomic changes that may increase the risk of anterior chamber implant migration in patients with congenital glaucoma so that physicians may be aware of these risks when selecting patients for this implant.

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Section: Discussionmentioning

confidence: 99%

Dexamethasone implant migration in an eye with congenital glaucoma: A case report and review of the literature

Chang

Peter

et al. 2021

European Journal of Ophthalmology

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“…Over the past decade, there have been an increasing number of case reports describing the migration of DEX implants into the anterior chamber (AC). 2 – 13 Some of these cases have been effectively managed with a combination of patient positioning, dilation, and gentle tapping on the eye, permitting repositioning of the implant back into the vitreous cavity. 3 , 5 Others have described urgent surgical removal of the implant from the AC.…”

Section: Introductionmentioning

confidence: 99%

Management and Complications of Dexamethasone Intravitreal Implant Migration Into the Anterior Chamber

Betsch

Gupta

2022

Journal of VitreoRetinal Diseases

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Purpose: To report patient demographics, the clinical course, and visual outcomes across a case series of patients who experienced dexamethasone (DEX) intravitreal implant (Ozurdex, Allergan, Inc) migration into the anterior chamber (AC), with a focus on the corneal transplantation rate. Methods: In this retrospective cross-sectional study, a chart review of all cases was performed. For numerical responses, means and SDs were calculated. Percentages and absolute numbers were used to report the proportion of patients who experienced various outcomes of interest. Results: The study comprised 32 cases. All cases occurred in pseudophakic eyes; of those, 8 (25.0%) had posterior chamber intraocular lenses in the capsular bag with no known capsular or zonular issues. The mean duration from DEX implant injection to detection of migration was 19.4 ± 14.5 days. The DEX implant was explanted in 21 patients (65.6%) and repositioned in the vitreous cavity or subconjunctival space in 6 patients (18.8%). Twelve patients (37.5%) ultimately required corneal transplantation. Conclusions: To our knowledge, this is the largest case series of DEX intravitreal implant migration into the AC compiled to date. Cases of migration occurred in individuals with no known history of significant prior zonule disruption. This potential complication should be discussed with all patients undergoing DEX implant injection, which may aid in earlier presentation and improved visual outcomes.

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“…Anterior migration of a dexamethasone implant therefore requires urgent removal or repositioning of the implant to avoid permanent ocular damage. [1][2][3][4] Although anterior migration of dexamethasone implants necessitates a surgical approach, other implants may not pose the same risks to patients.…”

mentioning

confidence: 99%

Anterior Migration of Intravitreal Fluocinolone Acetonide Implants: A Case Report

Gunzenhauser

Greven

John

2022

RETINAL Cases &Amp; Brief Reports

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Background/Purpose: To describe management of anterior migration of a fluocinolone acetonide(FAc) intravitreal implant.Methods: A retrospective case report. A 61-year-old man with diabetic macular edema and prior vitrectomy had anterior migration of a FAc implant. Anterior segment photos and optical coherence tomography were performed.Results: Approximately 3 months after FAc implant was administered, it was noted to have migrated into the anterior chamber. Vision, intraocular pressure, and optical coherence tomography imaging initially remained stable, and no evidence of detectable corneal edema developed in 30 months of follow-up. However, at 36 months of follow-up, after second FAc implant injection, mild corneal edema developed,suspected to be related to the migrating implants.Conclusion: Anterior migration of a FAc implant may lead to less rapid and severe corneal decompensation compared with other steroid implants. Despite this, delayed corneal edema may occur. Careful monitoring of the cornea and intraocular pressure is recommended in cases of anterior FAc migration.

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Corneal toxicity after Ozurdex® migration into anterior chamber

Cited by 5 publications

References 6 publications

Dexamethasone implant migration in an eye with congenital glaucoma: A case report and review of the literature

Dexamethasone implant migration in an eye with congenital glaucoma: A case report and review of the literature

Management and Complications of Dexamethasone Intravitreal Implant Migration Into the Anterior Chamber

Anterior Migration of Intravitreal Fluocinolone Acetonide Implants: A Case Report

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