Persistent bilateral sclerouveitis following bimatoprost implantation and removal

To report a case of persistent bilateral sclerouveitis following bilateral bimatoprost implantation (Durysta) that required implant removal and oral steroid course.

A 75-year-old Caucasian male with no prior ocular inflammation experienced bilateral sclerouveitis post bilateral bimatoprost implantation. Despite implant removal from both eyes, the ocular inflammation persisted, showing cystoid macular edema in both eyes and exudative retinal detachment in the right. A comprehensive assessment revealed no clear etiology and no definitive systematic inflammatory syndrome. The ocular inflammation was unresponsive to topical steroids and only receded following weeks-long course of oral steroids. Eventually, the patient required immunosuppression due to recurrence of the inflammation.

The persistence and severity of this inflammatory response to bimatoprost implants, despite its removal, highlight the importance of considering patient-specific risk factors and tailoring management accordingly. Clinicians should be prepared for possible severe reactions requiring intervention.