Indian Journal of Ophthalmology

PHOTO ESSAY
Year
: 2019  |  Volume : 67  |  Issue : 2  |  Page : 268--269

Anterior chamber migration of intravitreal dexamethasone implant in glued intraocular lens


Dhivya Ashok Kumar, Atul Dhawan, Soumya Narayanan, Amar Agarwal 
 Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Dhivya Ashok Kumar
Dr. Agarwal's Eye Hospital and Eye Research Centre, 19, Cathedral Road, Chennai, Tamil Nadu - 600 086
India

Abstract




How to cite this article:
Kumar DA, Dhawan A, Narayanan S, Agarwal A. Anterior chamber migration of intravitreal dexamethasone implant in glued intraocular lens.Indian J Ophthalmol 2019;67:268-269


How to cite this URL:
Kumar DA, Dhawan A, Narayanan S, Agarwal A. Anterior chamber migration of intravitreal dexamethasone implant in glued intraocular lens. Indian J Ophthalmol [serial online] 2019 [cited 2019 Dec 12 ];67:268-269
Available from: http://www.ijo.in/text.asp?2019/67/2/268/250686


Full Text



 Cases



Case 1: A 61-year-old hypertensive male with glued intraocular lens (IOL) implantation 2 years ago presented with decreased vision in his right eye. Ozurdex implant was injected intravitreally a week ago for refractory macular edema. On examination, the right eye had well-centered glued IOL with corneal edema [Table 1], iris defect at 10 o'clock, and migrated Ozurdex implant [Figure 1] in the anterior chamber (AC).{Table 1}{Figure 1}

Case 2: A 57-year-old diabetic male with glued IOL implantation with Ozurdex injection for diabetic macular edema [Figure 2]a and [Figure 2]b 3 weeks ago presented with decreased vision in his right eye. On examination, there was implant migration into the AC [Figure 3]a and [Figure 3]b with centered glued IOL.{Figure 2}{Figure 3}

Under peribulbar anesthesia using the viscoelastic device the implant was made to align perpendicular to the long axis of the incision and explanted with viscoexpression [Figure 3]a and [Figure 3]b by counter pressure on the posterior lip. Case 2 required pre Descemet's endothelial keratoplasty (PDEK) for corneal decompensation [Figure 3]c, [Figure 3]d, [Figure 3]e, [Figure 3]f after a month.

 Discussion



Ozurdex migration into the AC was initially reported with iris-fixated IOL requiring corneal transplantation.[1],[2] Owing to the proximity to the uvea, the sulcus, AC IOL, or iris fixated IOLs may require steroid implants to control inflammation.[3],[4] However, the inflammatory response is less with glued IOL.[5] Both cases in our report had corneal edema, whereas case 2 required PDEK. The proximity to the endothelium and the greater rigidity of the implant soon after injection may be the probable risk factors for corneal edema. Deficient capsules, iridectomy, zonular dialysis, and prior vitrectomy are known threats for implant migration. Our report showed that even a well-centered glued IOL may not prevent this migration, and hence, the need for meticulous follow-up should be emphasized.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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