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Migration of intravitreal dexamethasone implant to anterior chamber
Vamsi K Gullapalli1, David A DiLoreto
1Flaum Eye Institute, Retina Service, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Purpose:
To describe two cases of migration of intravitreally injected dexamethasone implant into the anterior chamber.
Methods:
Charts were reviewed of two patients who received sustained-release dexamethasone implant intravitreally for chronic intractable cystoid macular edema.
Results:
Both patients had pseudophakic cystoid macular edema and a complicated clinical course before receiving the implant. Treatments before intravitreal injection of implant included topical nonsteroidal anti-inflammatory drugs, sub-Tenon triamcinolone injections, vitrectomy, and, in one case, intravitreal bevacizumab. Both patients responded well to triamcinolone injections but required repeated injections. This led to the decision to inject the implant. Within 2 weeks of injection, the implant was noted in the anterior chamber causing pain and decreased vision from corneal edema. Both patients underwent successful removal of the implant.
Conclusion:
Sustained-release intravitreal injectable implants can migrate freely in vitrectomized pseudophakic or aphakic eyes. Selection of a scleral-fixated steroid implant might be safer in such cases.
