Pupilloplasty to prevent dexamethasone intravitreal implant migration to anterior chamber

Description

We present a case of a 84-year-old man, treated with dexamethasone intravitreal implant (Ozurdex®) for Irvine-Gass syndrome after complicated cataract surgery, with subsequent vitrectomy and retropupillar positioning of iris-fixated intraocular lens. Four weeks after the implantation, the patient presented with the implant in the anterior chamber. To prevent corneal oedema, the implant was removed the day after. After evaluating the anterior segment, the communication between the vitreal cavity and the anterior chamber, through which the implant has migrated, was found (figure 1A). The cystoid macular oedema (CME) reappeared (figure 2A), so, the patient was submitted to pupilloplasty and implantation of dexamethasone intravitreal implant in the same procedure (figure 1B). Two months after the implantation, the CME has significantly improved (figure 2B) and there was no new migration of the implant.

Figure 1

(A) Anterior segment photography after...

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