The clinical outcomes of surgical management of anterior chamber migration of a dexamethasone implant (Ozurdex®)

Hyunseung Kang, Min Woo Lee, Suk Ho Byeon, Hyoung Jun Koh, Sungchul Lee, Min Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: Our purpose was to describe the clinical course, and individualized management approaches, of patients with migration of a dexamethasone implant into the anterior chamber. Methods: This was a retrospective review of four patients with seven episodes of anterior chamber migration of a dexamethasone implant. Results: After 924 intravitreal dexamethasone injections, anterior migration of the implant occurred in four eyes of four patients (0.43%). All four eyes were pseudophakic: one eye had a posterior chamber intraocular lens in the capsular bag but in a post-laser posterior capsulotomy state, two eyes had a sulcus intraocular lens (IOL), and one eye had an iris-fixated retropupillary IOL. All eyes had a prior vitrectomy and no lens capsule. The time interval from injection to detection of the implant migration ranged from 2 to 6 weeks. Of the four eyes with corneal edema, only one eye required a corneal transplantation, although it was unclear whether the implant migration was the direct cause of the corneal decompensation because the patient had a history of bullous keratopathy resulting from an extended history of uveitis. All patients underwent surgical intervention: two patients with a repositioning procedure, and the other two patients with removal due to repeated episodes, although surgical removal was not always necessary to reverse the corneal complications. Conclusions: In our study, not all patients required surgical removal of the implants. Repositioning the implant back into the vitreous cavity may be considered as an option in cases involving the first episode with no significant corneal endothelial decompensation. Considering potential anterior segment complications and the loss of drug effectiveness together, an individualized approach is recommended to obtain the best treatment outcomes and to minimize the risk of corneal complications.

Original languageEnglish
Pages (from-to)1819-1825
Number of pages7
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume255
Issue number9
DOIs
Publication statusPublished - 2017 Sep 1

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Anterior Chamber
Dexamethasone
Intraocular Lenses
Posterior Capsulotomy
Corneal Edema
Intravitreal Injections
Corneal Transplantation
Vitrectomy
Uveitis
Iris
Lenses
Capsules
Injections
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

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title = "The clinical outcomes of surgical management of anterior chamber migration of a dexamethasone implant (Ozurdex{\circledR})",
abstract = "Purpose: Our purpose was to describe the clinical course, and individualized management approaches, of patients with migration of a dexamethasone implant into the anterior chamber. Methods: This was a retrospective review of four patients with seven episodes of anterior chamber migration of a dexamethasone implant. Results: After 924 intravitreal dexamethasone injections, anterior migration of the implant occurred in four eyes of four patients (0.43{\%}). All four eyes were pseudophakic: one eye had a posterior chamber intraocular lens in the capsular bag but in a post-laser posterior capsulotomy state, two eyes had a sulcus intraocular lens (IOL), and one eye had an iris-fixated retropupillary IOL. All eyes had a prior vitrectomy and no lens capsule. The time interval from injection to detection of the implant migration ranged from 2 to 6 weeks. Of the four eyes with corneal edema, only one eye required a corneal transplantation, although it was unclear whether the implant migration was the direct cause of the corneal decompensation because the patient had a history of bullous keratopathy resulting from an extended history of uveitis. All patients underwent surgical intervention: two patients with a repositioning procedure, and the other two patients with removal due to repeated episodes, although surgical removal was not always necessary to reverse the corneal complications. Conclusions: In our study, not all patients required surgical removal of the implants. Repositioning the implant back into the vitreous cavity may be considered as an option in cases involving the first episode with no significant corneal endothelial decompensation. Considering potential anterior segment complications and the loss of drug effectiveness together, an individualized approach is recommended to obtain the best treatment outcomes and to minimize the risk of corneal complications.",
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The clinical outcomes of surgical management of anterior chamber migration of a dexamethasone implant (Ozurdex®). / Kang, Hyunseung; Lee, Min Woo; Byeon, Suk Ho; Koh, Hyoung Jun; Lee, Sungchul; Kim, Min.

In: Graefe's Archive for Clinical and Experimental Ophthalmology, Vol. 255, No. 9, 01.09.2017, p. 1819-1825.

Research output: Contribution to journalArticle

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AU - Kim, Min

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