Mariana Batista Gonçalves1, Bruno de Queiroz Alves1, Raphael Moura1, Octaviano Magalhães1, André Maia1, Rubens Belfort1, Marcos Pereira de Ávila2, Marcelo Zas3, Mario Saravia4, Marcia Lousas4, Lihteh Wu5, J Fernando Arevalo6, Katia Delalibera Pacheco7, Taylor Johnson1, Michel Eid Farah1, Francisco Jose Rodriguez8, Mauricio Maia1. 1. Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil. 2. Ophthalmology Department, Universidade Federal de Goiás, Goiania, Brazil. 3. Retina Section, Ophthalmology Department, Hospital de Clinicas Jose de San Martin, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina. 4. Department of Ophthalmology, Universidad Austral, Buenos Aires, Argentina. 5. Vitreo-retinal Department, Instituto de Cirugia Ocular, San Jose, Costa Rica. 6. Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. 7. Retina Division, Brazilian Center of Vision Eye Hospital, Brasília, DF, Brazil; and. 8. Retina Division, Fundacion Oftalmologica da Colombia (Fundonal), Universidad del Rosario, Bogotá, Colombia.
Abstract
PURPOSE: To establish the prevalence and risk factors for intravitreal dexamethasone implant migration into the anterior chamber in eyes with macular edema. METHODS: This was a multicenter, retrospective, observational chart review of data that included patients with macular edema who had been treated with at least one intravitreal dexamethasone injection. Patients with incomplete chart information during the follow-up period were excluded. RESULTS: The prevalence of implant migration in 468 patients, considering the number of injections, was 1.6%, with significant associations between implant migration and cataract surgery (P = 0.043) and intraocular lens status (P = 0.005) and a trend toward statistical significance (P = 0.057) with vitrectomy. A higher rate of implant migration into the anterior chamber was observed in vitrectomized eyes (4.8%) when compared with patients who did not undergo a vitrectomy (1.6%). The implants that migrated were removed with forceps with/without viscoelastic expression or with 20-gauge cannulas connected to the vitreous cutter machine. CONCLUSION: The risk of implant migration into the anterior chamber was 1.6%. Risk factors were a history of cataract surgery or vitrectomy and aphakia. When anterior migration occurs, rapid removal is advised, especially if corneal edema is present.
PURPOSE: To establish the prevalence and risk factors for intravitreal dexamethasone implant migration into the anterior chamber in eyes with macular edema. METHODS: This was a multicenter, retrospective, observational chart review of data that included patients with macular edema who had been treated with at least one intravitreal dexamethasone injection. Patients with incomplete chart information during the follow-up period were excluded. RESULTS: The prevalence of implant migration in 468 patients, considering the number of injections, was 1.6%, with significant associations between implant migration and cataract surgery (P = 0.043) and intraocular lens status (P = 0.005) and a trend toward statistical significance (P = 0.057) with vitrectomy. A higher rate of implant migration into the anterior chamber was observed in vitrectomized eyes (4.8%) when compared with patients who did not undergo a vitrectomy (1.6%). The implants that migrated were removed with forceps with/without viscoelastic expression or with 20-gauge cannulas connected to the vitreous cutter machine. CONCLUSION: The risk of implant migration into the anterior chamber was 1.6%. Risk factors were a history of cataract surgery or vitrectomy and aphakia. When anterior migration occurs, rapid removal is advised, especially if corneal edema is present.
Authors: Giancarlo Sborgia; Alfredo Niro; Francesco D'Oria; Alessandra Galeone; Luigi Sborgia; Francesco Boscia; Alessandra Sborgia; Giovanni Alessio Journal: Case Rep Ophthalmol Med Date: 2020-02-10