Anterior segment migration of dexamethasone implant: risk factors, complications, and management

Abstract

Purpose of review: To describe the risk factors, clinical course, and complications related to anterior segment migration of a dexamethasone (DEX) intravitreal implant, and review over potential management strategies.

Recent findings: Recent reports have demonstrated that migration of a DEX implant into the anterior chamber may occur in patients with higher risk ocular characteristics. Although a relatively rare occurrence, DEX implant migration carries the possibility of inducing potentially vision-threatening corneal endothelial decompensation and edema.

Summary: Any combination of previous pars plana vitrectomy, an open/defective lens capsule, and/or iris defects may increase the risk of DEX implant migration into the anterior chamber. In the setting of a DEX implant that has moved into the anterior segment with corneal edema already present, urgent removal of the implant is warranted to reduce the risk of permanent visual compromise.