Late Migration of Dexamethasone Implant Into Anterior Chamber

Cronin, Kevin M.; Govind, Kishan; Kurup, Shree K.

doi:10.1001/archophthalmol.2011.1595

Cited by 14 publications

(8 citation statements)

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“…Most case reports describe migration of the implant into the anterior chamber in eyes that had previous cataract surgery complicated by posterior capsule rupture. (Cronin et al 2012;Pardo-L opez et al 2012;Malcl es et al 2013) Only one article reports a case similar to ours, describing cataract surgery after implant in the crystalline lens. (Koller et al 2012) Several conclusions can be drawn from this case series.…”

Section: Accidental Injection Of Dexamethasone Intravitreal Implant Imentioning

confidence: 51%

Accidental injection of dexamethasone intravitreal implant in the crystalline lens

Fasce

Parodi

Knutsson

et al. 2013

Acta Ophthalmologica

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Section: Accidental Injection Of Dexamethasone Intravitreal Implant Imentioning

confidence: 51%

Accidental injection of dexamethasone intravitreal implant in the crystalline lens

Fasce

Parodi

Knutsson

et al. 2013

Acta Ophthalmologica

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“…Alternatively, the implant may be repositioned during vitrectomy so that it is not in the visual axis. Nevertheless, vitrectomized eyes have a greater likelihood of anterior segment migration, and several authors have suggested that vitrectomy is an important risk factor for migration [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone Implant-associated Vitreous Floaters and Symptom Improvement by YAG Laser Vitreolysis

Ahn

Kim

Lee

et al. 2018

J Retin

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Purpose:To investigate the incidence of symptomatic floaters following intravitreal dexamethasone implant therapy and to propose implant repositioning using neodymium-doped yttrium aluminum garnet (Nd:YAG) vitreolysis around the implant for treatment. Case summary: Nd:YAG vitreolysis was performed on the superior vitreous adjacent to the dexamethasone implant in eyes with persistent symptomatic floaters following intravitreal dexamethasone implant injection using 2.0-3.0 mJ energy. Among 172 injections of the dexamethasone implant, 11 (6.4%) resulted in symptomatic floaters at the 1-month visit. Three (1.7%) eyes exhibited persistent and visually significant vitreous floaters, upon which Nd:YAG vitreolysis was performed. Immediately after the superior vitreolysis adjacent to the implant, the implants were repositioned to the inferior vitreous. Floater symptoms were resolved in all patients without any damage to the implant or other ocular complications. Conclusions: Superior vitreolysis adjacent to dexamethasone implants may be an effective and safe treatment for persistent symptomatic floaters following intravitreal dexamethasone implant injection.

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“…Despite this evidence, the choice of the technique adopted should depend on the location and positioning of the dexamethasone implant relative to other intraocular structures. Thus, surgical procedures are sometimes inevitable to relocate the implant and to manage corneal decompensation and elevated intraocular pressure [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Management of anterior chamber dislocation of a dexamethasone intravitreal implant: a case report

et al. 2016

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BackgroundOzurdex is a 700 mcg dexamethasone intravitreal implant, approved for the management of macular edema secondary to retinal vein occlusion, and other related pathoglogiesAnterior chamber dislocation of Ozurdex represents an uncommon complication of the intravitreal injection, which can be managed by repositioning the implant into the vitreous cavity. We describe the case of a successful repositioning of an Ozurdex implant by mobilization and subsequent balanced saline solution injection in the anterior chamber.Case presentationAn 83-year-old white woman presented to our Emergency Unit complaining of pain and vision loss in herright eye lasting a week. Her anamnesis revealed a history of persistent cystoid macular edema after phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation, recently treated with an intravitreal Ozurdex implant. She also took a long-distance flight 2 days after the injection.An anterior segment examination showed corneal edema and the rod implant adherent to corneal endothelium. To avoid corneal decompensation, we opted for a implant repositioning. Under topical anesthesia, a 30-gauge needle was introduced through a limbar incisionto mobilize the dislocated rod. Balanced saline solution was injected, with a successful repositioning of the implant into the vitreous cavity. Topical 5 % hypertonic saline solution and 0.2 % betamethasone associated with 0.5 % chloramphenicol drops were administered four times a day. To prevent redislocation of the Ozurdex implant, she was instructed to avoid prone position, any kind of physical effort, and not to undertake long-distance flights during the first postoperative week. One week after surgery, an anterior segment examination showed an improvement of corneal edema. Funduscopy showed that the Ozurdex implant was settled into the vitreous cavity.ConclusionsAnterior chamber dislocation of Ozurdex from the vitreous cavity is rare. In our patient, in addition to the posterior capsule tearing, the long-distance flight could have contributed to implant dislocation. Repositioning of the implant is necessary to avoid endothelial decompensation. It can be carried out by using saline balanced solution with the same efficacy as other surgical procedures reported in the literature. A possible disadvantage of this procedure could be implant migration.

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Late Migration of Dexamethasone Implant Into Anterior Chamber

Cited by 14 publications

References 0 publications

Accidental injection of dexamethasone intravitreal implant in the crystalline lens

Accidental injection of dexamethasone intravitreal implant in the crystalline lens

Dexamethasone Implant-associated Vitreous Floaters and Symptom Improvement by YAG Laser Vitreolysis

Management of anterior chamber dislocation of a dexamethasone intravitreal implant: a case report

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