scholarly journals Dexamethasone implant (Ozurdex®) migration to anterior chamber through a congenital iris coloboma: A case report

2019 ◽  
Author(s):  
Yoav Glidai ◽  
Shulamit Schwartz ◽  
Eyal Cohen
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Cystoid Macular Edema ◽  
Corneal Edema ◽  
Lens Capsule ◽  
Prior History ◽  
Dexamethasone Implant ◽  
Implant Migration ◽  
First Case ◽  
History Of

Abstract Background: Ozurdex® 0.7 mg (dexamethasone 0.7 mg implant, Allergan, Dublin, Ireland), an intra-vitreal biodegradable implant indicated for cystoid macular edema due to variable causes. One of its known complications is implant migration to the anterior chamber, causing corneal edema that in some cases might be irreversible. Reported risk factors for device migration are open or defective lens capsule and prior history of vitrectomy. We present a case of dexamethasone implant migration through a congenital iris coloboma in a pseudophakic patient with intact lens capsule. Case presentation: 56-year-old pseudophakic man with a history of congenital iris coloboma, myopia, retinal tears and a Branch Retinal Vein Occlusion (BRVO) with subsequent Cystoid Macular Edema (CME) which was resistant to anti-VEGF medications but responsive to corticosteroids. He presented with sudden painless decreased vision in his left eye, eight weeks after dexamethasone implant (Ozurdex®) injection to the same eye. Upon presentation he was diagnosed with corneal edema caused by anterior chamber migration of the implant. He was referred for immediate surgical intervention and the implant was extracted, with the edema completely resolved within two weeks post-op. Conclusions: This is the first case reported of implant migration through an iris coloboma in the setting of intact posterior capsule. In addition, we describe a novel approach for implant removal surgery that is simple and efficient. This case sheds a light on another risk factor that should be taken into consideration in the management of this patient population.

scholarly journals Dexamethasone Implant Migration through an Iris Coloboma

2020 ◽  
Vol 11 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Yoav Glidai ◽  
Shulamit Schwartz ◽  
Eyal Cohen
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Cystoid Macular Edema ◽  
Corneal Edema ◽  
Lens Capsule ◽  
Prior History ◽  
Dexamethasone Implant ◽  
Implant Migration ◽  
First Case ◽  
History Of

Ozurdex® 0.7 mg (dexamethasone 0.7 mg implant, Allergan, Dublin, Ireland), an intravitreal biodegradable implant, is indicated for cystoid macular edema due to various causes. One of its known and uncommon complications is implant migration to the anterior chamber, causing corneal edema that, in some cases, is irreversible. Reported risk factors for device migration are open or defective lens capsule and prior history of vitrectomy. We present a case of dexamethasone implant migration through a congenital iris coloboma in a pseudophakic patient with an intact lens capsule. The patient is a 56-year-old pseudophakic man with a history of congenital iris coloboma, myopia, retinal tears, and a branch retinal vein occlusion with subsequent cystoid macular edema resistant to anti-VEGF medications but responsive to corticosteroids. He presented with sudden painless decreased vision in his left eye, 8 weeks following dexamethasone implant (Ozurdex) injection to the same eye. Upon presentation, he was diagnosed with corneal edema caused by anterior chamber migration of the implant. He was referred for immediate surgical intervention to extract the implant, with a resolution of the corneal edema within 2 weeks postoperatively. To conclude, this is the first case that reports Ozurdex implant migration through an iris coloboma in the setting of an intact posterior capsule. In addition, we describe a novel surgical approach for implant removal from the anterior chamber that is simple and efficient.

The Fate of Eyes with Anterior Chamber Intra-Ocular Lenses

1993 ◽  
Vol 3 (1) ◽  
pp. 42-46 ◽  
Author(s):  
R. David ◽  
R. Yagev ◽  
M. Shneck ◽  
D. Briscoe ◽  
E. Gilad ◽  
...  
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Cystoid Macular Edema ◽  
Corneal Edema ◽  
Visual Outcome ◽  
Cataract Extraction ◽  
Posterior Chamber ◽  
Extracapsular Cataract Extraction ◽  
Flexible Loop ◽  
Posterior Chamber Iol

A total of 143 anterior chamber (AC) intra-ocular lenses (IOL) of various designs were implanted in a five-year period and followed for 18 to 76 months. The lenses were inserted as a secondary implant after extracapsular cataract extraction (ECCE) complicated by vitrectomy, or after primary intra-capsular extraction. The complications (corneal edema, uveitis/glaucoma, extrusion/imbedding, cystoid macular edema), the final visual acuity and the need for removal of the IOL were analyzed. Only small differences were found between the different lenses but some association was found between complicated surgery (ECCE + vitrectomy) and a higher rate of complication, poorer visual outcome and more frequent need for IOL removal. Cystoid macular edema was encountered only in cases with complicated ECCE. A high percentage of other ocular pathologies was found among the cases, possibly implying that diseased eyes are more prone to surgical complications. An alternative to the AC-IOL in cases with a ruptured posterior capsule is the suture-supported posterior chamber IOL, but the flexible-loop AC-IOL may not yet be obsolete.

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

2021 ◽  
pp. 112067212110056
Author(s):  
Sarah M Chang ◽  
Deidre M St. Peter ◽  
Lily T Im ◽  
Wuqaas M Munir ◽  
Lisa S Schocket
Keyword(s):  
Case Report ◽  
Macular Edema ◽  
Anterior Chamber ◽  
Structural Changes ◽  
Congenital Glaucoma ◽  
Review Of The Literature ◽  
Management Options ◽  
White Line ◽  
Implant Migration ◽  
History Of

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.

Intravitreal Dexamethasone Implant for Cystoid Macular Edema and Inflammation after Scleral Buckling

2015 ◽  
Vol 25 (5) ◽  
pp. e98-e100 ◽  
Author(s):  
Vincenza Bonfiglio ◽  
Matteo R. Fallico ◽  
Andrea Russo ◽  
Vittorio De Grande ◽  
Antonio Longo ◽  
...  
Keyword(s):  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Scleral Buckling ◽  
Dexamethasone Implant ◽  
Intravitreal Dexamethasone Implant ◽  
Intravitreal Dexamethasone

scholarly journals Scleral fixation of a dexamethasone intravitreal implant in a case of subluxated bag–intraocular lens complex

2019 ◽  
Vol 11 ◽  
pp. 251584141985652
Author(s):  
Carlos M. Rangel ◽  
Nathalia J. Moreno ◽  
M. Margarita Parra
Keyword(s):  
Macular Edema ◽  
Anterior Chamber ◽  
Intraocular Lens ◽  
Corneal Edema ◽  
Conventional Technique ◽  
Endothelial Damage ◽  
Scleral Fixation ◽  
Surgical Tool ◽  
Number Of Patients ◽  
Capsular Support

Macular edema is a condition of retinal tissue treated with anti-inflammatory agents including placement of an intravitreal sustained-release dexamethasone device, designed to deliver a controlled amount of the medication for a prolonged time, representing an excellent therapy. Nonetheless, the implantation cannot be carried out without an anatomical barrier, such as the presence of posterior capsular support, lens, or intraocular lens. The absence of these barriers could lead to several complications, due to migration of the device from the vitreous cavity to the anterior chamber, causing corneal endothelial damage, corneal edema, glaucoma, and uveitis, among others. In consequence, a large number of patients cannot be treated with this useful surgical tool, resulting in chronicity of macular edema and severe visual acuity impairment. Therefore, we modified the conventional technique, through scleral fixation of the device providing a continuous delivering of dexamethasone, avoiding its migration to the anterior chamber in a patient without capsular support.

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