Ali M AL-Halafi^1,2, Abdulaziz M Al-Hadlaq^1,3, Shaaban Abd-Elhamid Mehany Elwan^1,4*

¹phthalmology Department, Security Forces Hospital, Riyadh, Saudi Arabia
²Ophthalmology Department, Faculty of Medicine, Prince Noura University, Riyadh, Saudi Arabia
³Ophthalmology Department, College of Medicine, Qassim University, Qassim, Saudi Arabia
⁴Ophthalmology Department, Faculty of Medicine, Minia University, El-Minia, Egypt

*Corresponding Author: Shaaban Abd-Elhamid Mehany Elwan, Professor of Ophthalmology, Faculty of Medicine, Minia University, Minia, Egypt.

Received: January 20, 2025; Published: January 31, 2025

Abstract

Purpose: We report this case of a patient with anterior chamber migration of intravitreal dexamethasone implant as well as its management and outcome.

Methods: The patient had the following sequence of events: Lasik surgery 10 years ago, OD, rhematogenous retinal detachment (RRD) surgery 3 years ago with pars plana vitrectomy (PPV), endolaser and silicone oil injection. Followed after 1 year by OD, cata ract surgery with PC, IOL and silicone oil removal. Later on she had diagnosed as persistent diabetic macular edema (DME) with several Anti-VEGF intravetrial injections ended by Ozurdex implants. Finally 6 weeks later and history of YAG laser posterior capsu lotomy she had done implant surgical removal after anterior chamber migration and corneal edema.

Results: Dexamethasone implant had been surgically explanted from the eye 6 weeks after insertion without any complication.

Conclusion: A surgical approach for removal of Ozurdex implant is essential if the patient suffering corneal edema due to implant anterior segment migration prior to corneal decompensation. Physicians should inform patients with PPV to the risk of implant mi gration. It is crucial to emphasize the importance of seeking immediate attention in the event of any decrease or change in vision as seek urgent medical consultation and timely intervention can be critical in preventing potential complications.

Keywords: Anterior Chamber Migration; Diabetic Macular Edema; Intravitreal Ozurdex Implant

References

1. Haller JA., et al. “Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion”. Ophthalmology 117 (2010): 1134-1146.e3.
2. Lowder C., et al. “Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis”. Archives of Ophthalmology 129 (2011): 545-553.
3. Boyer DS., et al. “Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema”. Ophthalmology 121 (2014): 1904-1914.
4. Boyer DS., et al. “Dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients”. Retina 31 (2011): 915-923.
5. Scaramuzzi M., et al. “Repeated intravitreal dexamethasone implant (ozurdex) for diabetic macular EDEMA”. Retina 6 (2016): 1216-1222.
6. Pardo-Lopez D., et al. “Anterior chamber migration of dexamethasone intravitreal implant (Ozurdex)”. Graefe's Archive for Clinical and Experimental Ophthalmology 250 (2012): 1703-1704.
7. Majumdar B., et al. “Migration of dexamethasone implant (OZURDEX) into the anterior chamber in a pseudophakic eye with an intact capsular bag”. Indian Journal of Ophthalmology - Case Report2 (2023): 357.
8. Khurana RN., et al. “Dexamethasone implant anterior chamber migration: risk factors, complications, and management strategies”. Ophthalmology 121 (2014): 67-71.
9. Kocak N., et al. “Anterior migration of dexamethasone implant in a pseudophakic patient with intact posterior capsule”. Indian Journal of Ophthalmology 62 (2014): 1086-1088.
10. Goncalves MB., et al. “Intravitreal dexamethasone implant migration into the anterior chamber: a multicenter study from the pan-american collaborative retina study group”. Retina5 (2020): 825-832.
11. Celik N., et al. “Complications of dexamethasone implants: risk factors, prevention, and clinical management”. International Journal of Ophthalmology10 (2020): 1612-20.
12. Majumder PD., et al. “Anterior chamber migration of a sustained-release dexamethasone intravitreal implant: a case report and review of literature”. Oman Journal of Ophthalmology2 (2019): 133-137.
13. Rahimy E and Khurana RN. “Anterior segment migration of dexamethasone implant: Risk factors, complications, and management”. Current Opinion in Ophthalmology3 (2017): 246-251.
14. Kayıkcıoglu O., et al. “Anterior chamber migration of ozurdex implants”. Turkish Journal of Ophthalmology2 (2020): 115-122.
15. Panagiotis Tsoutsanis and Dimitrios Kapantais. “Anterior migration of Ozurdex implant: a review on risk factors, complications, and management”. International Journal of Retina and Vitreous 9 (2023): 74.
16. Malcles A., et al. “Anterior chamber migration of intravitreal dexamethasone implant (Ozurdex®) in pseudophakic eyes: report of three cases (in French)”. Journal Français d'Ophtalmologie 36 (2013): 362-367.
17. Chen WL., et al. “In-vitro effects of dexamethasone on cellular proliferation, apoptosis, and Na+-K+-ATPase activity of bovine corneal endothelial cells”. Ocular Immunology and Inflammation 14 (2006): 215-223.
18. Zafar A., et al. “Uneventful anterior migration of intravitreal ozurdex implant in a patient with iris-sutured intraocular lens and descemet stripping automated endothelial keratoplasty”. Case Report on Ophthalmology1 (2018): 143-148.
19. Eadie JA., et al. “Migration of Ozurdex implant into the anterior chamber”. Retin Cases Brief Report 6 (2012): 269-270.
20. Vela JI., et al. “Repositioning of dexamethasone intravitreal implant (Ozurdex) migrated into the anterior chamber”. International Ophthalmology 32 (2012): 583-584.
21. Mateo C., et al. “Scleral fixation of dexamethasone intravitreal implant (Ozurdex) in a case of angle-supported lens implantation”. International Ophthalmology 34 (2014): 661-665.

Citation

Citation: Shaaban Abd-Elhamid Mehany Elwan. “Uneventful Anterior Migration of Intravitreal Dexamethasone Implant in a Diabetic Patient with Persistent Diabetic Macular Edema".Acta Scientific Ophthalmology 8.1 (2025): 11-17.

Copyright

Copyright: © 2025 Shaaban Abd-Elhamid Mehany Elwan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.